ENCYCLOPEDIA OF PUBLIC HEALTH D-K
DEMOGRAPHIC TRANSITION MEDICATIONS THAT INCREASE THE LEVELS OF DOPAMINE IN THE BRAIN PSYCHIATRIC DISORDERS LIKE DEPRESSION MAY CAUSE A DEMENTIA-LIKE IMPAIRMENT OF MEMORY AND CON- CENTRATION CALLED PSEUDODEMENTIA DEPRESSION IS A COMMON CONDITION IN THE ELDERLY PEOPLE WITH DEPRESSION OFTEN HAVE PROBLEMS WITH SLEEP, GUILT, APPETITE, SEXUAL DRIVE, LOW MOOD, LOW ENERGY, AND LOSS OF INTEREST IN ACTIVITIES, AND THEY MAY BE SUICI- DAL THEY ARE MORE LIKELY TO BE PESSIMISTIC AND COMPLAIN OF POOR MEMORY THAN A PERSON WITH TRUE ALZHEIMER’S DISEASE, WHO USUALLY TRIES TO DENY ANY PROBLEMS PSEUDODEMENTIA IMPROVES AFTER THE DE- PRESSION IS TREATED, USUALLY BY PSYCHOTHERAPY, MEDI- CATIONS, OR SOCIAL SUPPORT DEPRESSION MAY OCCUR IN SOME INDIVIDUALS WITH DEMENTIA AS THE PERSON BECOMES AWARE OF THE COGNITIVE DECLINE TREAT- MENT OF DEPRESSION MAY STILL BE VERY HELPFUL IN SUCH CASES DIAGNOSIS OF DEMENTIA REQUIRES A THOROUGH PHYSICAL, NEUROLOGICAL, AND PSYCHIATRIC EXAM NEUROPSYCHOLOGICAL TESTING CONSISTS OF A BATTERY OF COGNITION TESTS AND HELPS DETERMINE WHAT FUNC- TIONS ARE SPECI?CALLY IMPAIRED LABORATORY TESTS ARE REQUIRED AS PART OF THE MEDICAL EVALUATION OCCASIONALLY, BRAIN IMAGING IS USED IF A BRAIN TUMOR OR HEAD INJURY IS SUSPECTED (SEE ALSO: ALZHEIMER’S DISEASE; STROKE) BIBLIOGRAPHY KAPLAN, H , AND SADOCK, B , EDS (1995) COMPREHENSIVE TEXTBOOK OF PSYCHIATRY, VOL 1, 6TH EDITION BALTIMORE, MD: WILLIAMS AND WILLKINS KNOPMAN, D (1998) “THE INITIAL RECOGNITION AND DIAG- NOSIS OF DEMENTIA ” THE AMERICAN JOURNAL OF MEDICINE 104 (APRIL):2S–12S TIERNEY L ; MCPHEE, S ; AND PAPADAKIS, M (1999) “DEMENTIA ” IN CURRENT MEDICAL DIAGNOSIS AND TREAT- MENT, 38TH EDITION STAMFORD, CT: APPLETON AND LANGE DEMOGRAPHIC TRANSITION THE TERM “DEMOGRAPHIC TRANSITION” DENOTES THE EFFECTS ON POPULATION OF THE SOCIAL AND ECONOMIC FIGURE DEMOGRAPHIC TRANSITION: ENGLAND AND WALES RATE PER THOUSAND YEAR CRUDE BIRTH RATE CRUDE DEATH RATE SOURCE: CHESNAIS (1992) CHANGES OF THE INDUSTRIAL REVOLUTION, WHICH TRANS- FORMED EUROPE IN THE EIGHTEENTH AND NINETEENTH CENTURIES AND SPREAD TO THE REST OF THE WORLD IN THE TWENTIETH CENTURY IN SIMPLE TERMS THE COMPLETE TRANSITION WOULD BEGIN WITH A STATIONARY POPULA- TION WITH BIRTH AND DEATH RATES OF ABOUT 30 PER 1,000 PERSONS, A TRIANGULAR POPULATION PYRAMID, AND LIFE EXPECTANCY OF ABOUT 30 YEARS THE TRANSI- TION WOULD END WITH A STATIONARY POPULATION WITH BIRTH AND DEATH RATES OF 10 PER 1,000 PERSONS, AND A LIFE EXPECTANCY CLOSE TO THE BIOLOGICAL LIMIT OF YEARS THIS ?NAL STATE WAS NOT REACHED BY THE BEGINNING OF THE TWENTY-?RST CENTURY, BUT IN SOME DEVELOPED COUNTRIES THE LIFE EXPECTANCY OF FEMALES IS OVER 80 YEARS FIGURE 1 SHOWS AN EXAMPLE OF THIS TRANSITION, WITH DATA FOR ENGLAND AND WALES, THE ?RST COUNTRIES TO EXPERIENCE THE INDUSTRIAL REVOLUTION THE ?RST EFFECT OF THE TRANSITION WAS A REDUC- TION IN THE DEATH RATE, WHICH CONTINUED THROUGH- OUT THE TRANSITION PERIOD THE BIRTH RATE INCREASED SLIGHTLY AT ?RST, BUT LATER FELL TO THE SAME LOWER LEVEL AS THE DEATH RATE DURING THE TRANSITION, THE EXCESS BIRTH RATE OVER THE DEATH RATE (THE RATE OF NATURAL INCREASE) PRODUCED A LARGE INCREASE IN THE SIZE OF THE POPULATION NOT ALL EUROPEAN COUNTRIES EXPERI- ENCED THE TRANSITION IN EXACTLY THE SAME WAY IN PARTICULAR, THE FALL IN THE BIRTH RATE BEGAN IN FRANCE IN THE EARLY NINETEENTH CENTURY, AND LATER SPREAD TO