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Approach to Dementia (History (Loss of >2 Cognitive Function
Short…
Approach to Dementia
History
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Level of Function
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Does it results in safety issues like driving or cooking
(e.g. lost their way, involved in traffic incidents or left stove on)
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DSM 5 Definition
Progressive loss of cognitive function in > 2 domains
- amnestic (memory)
- non-amnestic (language, executive function, attention, visualspatial function
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Causes
Common
Vascular Dementia (VD)
Distinguishing Clinical Features
- stepwise or pregressive course
- vascular risk factors
- previous vascular events
- focal neurological deficits
- CT shows multiple infarctions
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Frontotemporal Dementia
Distinguishing Clinical Features
- early behavioral abnormalities
- obssessive-compulsive features
- PET can help distinguish from AD
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Alzheimer's Disease (AD)
Distinguishing Clinical Features
- relatively normal neuro exam
- language dysfunction
hippocampal atrophy on MRI
No lab abnormalities
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Mental State Assessment
MMSE
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Maximum Score 30
24 suggestive of Dementia
scores may be affected by education level
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