Patients are slow and slovenly, in contrast to the more alert behavior characterizing Alzheimer's disease. Pathogenesis is based on impeded CSF circulation and absorption. CT scans show large dilated ventricles. Slow disintegration of personality and intellect to to impaired insight and judgment and loss of affect. As the dementia develops aphasia, apraxia, agnosia may be present.
Remote memory is preserved until last stages.
This is commonly misdiagnosed as an affective disorder as depression, anxiety, or elation may result. Habits deteriorate and the patient becomes slovenly, dirty, and incontinent. In general people with systemic illnesses tend to develop attentional or frontal-subcortical cognitive problems rather than focal cognitive symptoms such as apraxia, acalculia or problems with visuospatial function. The EEG is almost always pathologically slow in organic dementia. Potentially toxic drugs should be reduced or discontinued.