Reversible Comorbidity in Irreversible Dementias
Medical and psychiatric comorbidities may also coexist in patients diagnosed with neurodegenerative or vascular dementia, which may aggravate their cognitive impairment. Sudden-onset or worsening symptoms, a temporally cognitive decline related with recent changes in medication, signs of infection, or systemic involvement and development of depression may be suggestive of superadded comorbidity. Emphasis must be placed on identifying and treating reversible concomitant conditions to offer a chance to reduce excess disability.
Even though they are a minority, reversible causes of dementia or dementia-like symptoms do exist, and they should be wisely investigated. High levels of suspicion must exist mainly when the cognitive profile and clinical presentation is atypical. Emphasis must be placed on promoting patients’ well-being and functionality, through the identification and prompt treatment of reversible causes of cognitive impairment and dementia. The same approach should be applied to superimposed conditions in patients with an already established dementia.