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Patient presenting with forgetfulness, MANAGEMENT IN FAMILY MED SETTING,…
Patient presenting with forgetfulness
ALZHEIMER’S
-Biomarkers suggestive of Alzheimer’s
-Early-insidious short term memory loss- Language deficits and space disorientation
-Later personality changes
-5 A's of Alzheimer's which include: Amnesia, Apraxia, Agnosia, Aphasia, and Anomia.
VASCULAR DEMENTIA
Most probable in our case... due to focal or diffused cerebral infarction- Stepwise decline
history of stroke(s)
-difficulty solving problems
-apathy
-disinhibition
*Risk factors
-age >60 years
-obesity
-hypertension
-cigarette smoking
MILD COGNITIVE IMPIRMENT
Doesnt affect daily activities to the extent as seen in vascular dementia or Alzheimer’s
AGE RELATED MEMORY DECLINE
Cognirive decline can be part or normal aging process if there are no red flags in assesment.
DRUG
Anti anxiety drugs like bromazepam can cause memory loss
RED FLAGS
Memory loss that affects day-to-day abilities
Difficulty performing familiar tasks
Problems with language
Disorientation to time and place
Impaired judgment
Problems with abstract thinking
Misplacing things
Changes in mood and behaviour
Changes in personality
Loss of initiative
Punding behaviour
MANAGEMENT IN FAMILY MED SETTING
Treat Co-Morbidities respectively
Pharmacotherapy according to diagnosis
-Stop Bromazepam and use alternative drug. Consider ssri?
Cognitive Behaviour therapy (CBT)
Nursing care
REFERENCES:
1-
VASCULAR DEMENTIA
https://bestpractice.bmj.com/topics/en-us/319
2- USMLE AID
3- uptodate.com
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