Journal of the American Psychiatric Nurses Association

In 1907 Alois Alzheimer published a case report of acognitively impaired woman who also exhibited the confusing symptoms of psychosis and agitation. Her most troublesome symptoms were suspicion of her husband and an irrational belief that people were out to kill her (Alzheimer, 1907). Alzheimer described what is now understood to be the characteristic “psy-chiatric symptoms ” of Alzheimer’s disease (AD); these symptoms are the real challenges in caring for a per-son with dementia. The term “dementia ” describes a syndrome of cog-nitive impairment with multiple causes such as strokes, substance abuse, head trauma, or human immunodeficiency virus. Some cases of dementia are reversible, but many times dementia is irreversible and progressive, such as with AD. Approximately 4 to 6 million people older than 65 years have dementia, but it is most common over the age of 85 years (Evans et al., 1989). AD is the most prevalent type of irreversible dementia (Cherrier et al., 1997; Guttman, Altman, & Nielsen, 1999; McKeith et al., 1996). It is estimated that 47 % of the persons over 85 years have symptoms of AD (Evans, 1990). There are at least two types of AD, early and late onset. In early onset, symptoms occur before the age of 65 years, and the disorder is more progressive than late onset, which starts after that age. Diagnosis The diagnosis of AD was made only after autopsy for many years. Today, there is general agreement that AD can be diagnosed through clinical assessment with standardized criteria set by groups such as th