Please enable JavaScript.
Coggle requires JavaScript to display documents.
TASK 2 - Coggle Diagram
TASK 2
Differential diagnosis
Lewy-Body dementia
Normal pressure Hydrocephalus
Frontotemporal dementia
Alzheimer's disease
Multi infarct dementia/ vascular dementia
Medications Adverse effects
Depression
Vitamin B12 levels
Thyroid function test ( for hypothyroidism)
Basic Metabolic Panel
CT scan without contrast (if MRI is contraindicated)
MRI without contrast
CBC ( to rule out anemia)
SCREENING TOOLS FOR ASSESSMENT OF COGNITION
Ascertain Demetia 8item informant questionnaire
General Practitioner Assessment of cognition,
Mini mental status Examination
Mini-Cog
Montreal Cognitive Assessment
Saint Louis University Mental Status Examination
CONDITIONS TO BE RULED OUT
Alzheimer's Disease (most common cause of dementia in elderly)
Depression ( as patient has past history of depression)
Delirium ( should always be ruled out prior to any testing because it invalidates any screening if present, patient has hx of UTI though not very recent but delirium is common in elderly and should always be considered)
Vascular dementia ( as patients has hypertension dyslipidemia plus family history of stroke)
Medications side effects ( patient is on opioid agonist, anticholinergic agent and benzodiazepine which are risk factors for dementia)
TASK 3
What types of dementia will you consider? Describe differentiating features.
ALZHEIMERS DEMENTIA :initial short-term memory loss
VASCULAR DEMENTIA : vascular risk factors; neuroimaging evidence of cerebrovascular involvement
• LEWY BODY DEMENTIA : bradykinesia or features of parkinsonism, fluuctuating cognition, visual hallucinations
• PARKINSON'S DISEASE DEMENTIA : dementia occurring > 1 y after onset of Parkinson disease
• FRONTOTEMPORAL DEMENTIA: younger age, behavioural symptoms, or language impairment
MANAGEMENT IN FAMILY MEDICINE
Non Pharmacological management
caregiver stress should be kept in mind and manage accordingly
Physiotherapy: for gait, balance etc
Environmental modification, rapid changes in surroundings can creates confusion
keeping clocks, calenders and pictures is useful for orientation
Occupational therapy: for hygeine, clothing, bathing etc.
Pharmacological management
For Dementia with Parkinsons disease: add dopamine agonists like carbidopa/levodopa and ropirinole
if psychiatric and behavioral changes are present: add antipsychotics ( with caution) and antidepressants
for Dementia : Cognitive enhancement, add anticholinesterase inhibitors
donepezil and aricept and advise shared care