=Delusional Type.=—A third type of Senile Dementia is the paranoid form. Dements of this type, owing to delusions of persecution and auditory hallucinations are sensitive and suspicious. Such cases may sometimes show good orientation, apparently unclouded minds, and little evidence of senility, requiring careful study to differentiate the condition from true paranoia. A patient may, on account of hallucinations of taste and smell, refuse food in the belief that it is poisoned. Members of his family who are devotedly caring for him are suspected of designs on his money, and this suspicious attitude frequently leads to unjust wills. The delusions and suspicions may be entirely concealed from the family. Wealthy paranoid elements are peculiarly apt to become the prey of scheming adventuresses, particularly in case of the above mentioned sexual recrudescence, and marry them. Opposition of the family is regarded as part of their general persecution or as due merely to their desire to get the estate. Some patients merely appear odd, suspicious, untidy, peevish, and childish. Some have expansive delusions and exhibit the euphoria so frequently found in syphilitic dements. =Senile Delirium.=—A fourth type has been described by some psychiatrists under the title of senile delirium. This may appear as the initial form of the disease or as an acute attack in one of the above forms. It is characterized by great incoherence and restlessness, entire absence of orientation, and numerous rapidly changing delusions and hallucinations, the condition resembling delirium tremens. It is probably due to some somatic cause, such as nephritis, pneumonia, or cystitis, which is often fatal. Complications may arise in Senile Dementia, such as apoplectic strokes, hemiplegia, epileptiform seizures and aphasias. =Prognosis.=—It is evident from the pathology of the conditions that the prognosis is not at all good when the disease is well advanced. It is a chronic disease and usually progressive until death, which is due to one of the complications, malnutrition, or especially pneumonia. However, many cases have shown improvement, and in incipient stages recovery. A cure of advanced cases being impossible, the important consideration is prevention or arrest in its incipiency.