Differential Diagnosis of Rapid Progressive Dementia

There is a broad range of diseases underlying dementia, of which Alzheimer’s disease is the most frequent in senile and pre-senile dementia. While senile dementia is predominantly caused by neurodegenerative or vascular disorders, in early-onset dementia other conditions are more relevant. Autoimmune, metabolic and genetic reasons should be evaluated, as well as toxic causes. A list of mutations associated with dementia is provided in this article. A higher proportion of potentially reversible conditions in pre-senile dementia highlights the value of detailed evaluation. Lumbar puncture is important in the diagnostic process to detect inflammatory changes, but dementia markers such as Aβ1–42 are also helpful in differential diagnosis. The value of cerebrospinal fluid markers for differential diagnosis is discussed in this article.