Your Global Health Resource

 1. Senile Dementia (Old Term)
What is it?
“Senile dementia” is a general, outdated term that used to refer to cognitive decline in older adults. Today, this term has been replaced by specific diagnoses such as Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, among others.

Causes:

• Neurodegenerative diseases (such as Alzheimer’s)
• Vascular diseases
• Vitamin deficiencies (such as B12)
• Untreated hypothyroidism
• Effects of medications or alcohol

Age and races most affected:

Over 65 years of age Affects all races, although African-American and Hispanic populations are at higher risk due to socioeconomic factors and comorbidities

Diagnosis:

• Clinical and functional history
• Neuropsychological testing
• Laboratory tests to rule out reversible causes Imaging such as MRI or CT

Treatments:
Depend on the specific type of dementia
Cholinesterase inhibitors, memantine
Nutritional, psychological, and occupational therapy support

2. Vascular Dementia
What is it?
It is caused by brain damage due to multiple infarcts (strokes) that affect blood flow to the brain.

Causes:

• High blood pressure
• Diabetes
• High cholesterol
• Heart disease
• History of stroke or small cerebral infarcts (microinfarcts)

Age and races most affected:

Higher frequency in those over 65 years of age More common in people of African descent and Asians, due to the prevalence of vascular risk factors.

Diagnosis:

• History of vascular events
• Neuroimaging (CT, MRI) showing infarcts or ischemic lesions
• Cognitive assessment

Treatments:
Aggressive control of cardiovascular risk factors (blood pressure, glucose, lipids) Aspirin or anticoagulants as indicated Cognitive and physical rehabilitation. There are no specific drugs to reverse it, but its progression can be prevented.

3. Alzheimer’s disease
What is it?
Progressive neurodegenerative disease. It is the most common cause of dementia. It is characterized by the abnormal accumulation of beta-amyloid and tau in the brain, leading to neuronal loss.

Causes:
In most cases, multifactorial: genetics, age, lifestyle, environmental factors. Early genetic form: mutations in APP, PSEN1, and PSEN2 genes

Age and races most affected:
Age: <65 years, but can begin in the fifth decade (early-onset Alzheimer’s)
Higher risk in women, African Americans, and Hispanics

Diagnosis:
Neuropsychological testing (MMSE, MoCA)
MRI (hippocampal atrophy)
CSF biomarkers: beta-amyloid, total tau, and phosphorylated tau
Brain PET (available at specialized centers)
New Treatments Tested (2024–2025):
Lecanemab and Donanemab: monoclonal antibodies that reduce beta-amyloid
plaques (approved in the US for certain (cases)
Dual anti-tau inhibitors in trials
Cognitive stimulation therapies + pharmacotherapy
Supplements such as omega-3, B12, and brain exercises as part of management
Quick Comparison:
Characteristic Alzheimer’s Vascular Dementia “Senile Dementia” 

Quick Comparison:
Characteristic Alzheimer’s Vascular Dementia “Senile Dementia” Primary Cause Neurodegenerative Cerebral infarcts Varied; obsolete term Onset Gradual Sudden or stepwise Gradual, attributed to age Early Symptoms Memory, orientation Attention, executive functions Diffuse mixing Brain Imaging Hippocampal atrophy Ischemic lesions Variable Current Treatment New anti-amyloid drugs Control of vascular factors
Individualized by cause Prognosis Progressive and irreversible Progressive but preventable Variable
Raul Ayala, MD
@MyDoctorOnCall.com