However, an article by Alzheimer's disease expert M.-Marsel Mesulam, M.D., in the Oct. 16 issue of The New England Journal of Medicine reports that nearly a quarter of all dementias, especially those of presenile onset, may be caused by diseases other than Alzheimer's disease and that some of these so-called atypical dementias involve cognitive abnormalities in areas other than memory.
Mesulam is Ruth and Evelyn Dunbar Professor of Psychiatry and Behavioral Sciences and professor of neurology at the Feinberg School of Medicine and director of the Cognitive Neurology and Alzheimer's Disease Center at Northwestern University.
Mesulam described, for example, primary progressive aphasia, an unusual dementia of unknown cause that is characterized by a relentless loss of language but with memory relatively preserved. Once considered a rare condition, primary progressive aphasia is now commonly included among dementia syndromes and has been reported in several hundred individuals.
Alzheimer's disease patients have forgetfulness, usually accompanied by apathy. They misplace personal objects, repeat questions and forget recent events. However, while these patients may forget people's names, word-finding during conversation is not a major problem.
In contrast, patients with primary progressive aphasia come to medical attention because of the onset of word-finding difficulties, abnormal speech patterns and glaring spelling errors. Some patients cannot find the right words to express their thoughts. Others cannot understand the mean
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