Pseudo‐Senility: Acute and Reversible Organic Brain Syndromes*

The cerebral blood flow in healthy elderly men is not notably different from that in 20‐year‐old control subjects. Only in the presence of a significant degree of arteriosclerosis is there a decrease in cerebral blood flow. Eventually there is a decrease in cerebral metabolic function associated with a decline in mentation. To explain much of the early mental change in many elderly persons, the environment must be assessed. In an 11‐year NIMH study of more than 600 variables, 2 factors proved to be accurate predictors of survival and mortality in the healthy elderly: (a) a new health indicator, viz, the organization of the subject's daily behavior; and (b) the presence or absence of chronic cigarette smoking. Behavior patterns of today's elderly are discussed. Pseudosenility, i.e., acute and potentially reversible mental change, is common in the elderly and may often be overlooked or misdiagnosed. Some causes are: medications, metabolic imbalance, depression, malnutrition, malignancy, hepatic disease, diminished cardiac output, cerebrovascular syndromes, febrile conditions, and chronic lung disease. Chronic, possibly reversible, mental syndromes include the depressions, dementias, deficiency states, and alcoholic encephalopathies. The treatment is outlined.