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Dementia Diagnosis and Management - Coggle Diagram

- - - - Limited sensitivity (misses mild dementia cases), does not label people with normal cognition as impaired, lacks executive function
      - Indications for usage
        
        Low education or literacy, MMSE is better
    - - Good sensitivity (picks up mild dementia cases), limited specificity, tests for executive function
- - - - Significant cognitive decline in 1+ domain (Complex attention, executive function, learning/memory, language, perceptual motor, socail cognition)
      - Interferes with independency of everyday activity
      - Severity
        
        Mild: Affects IADLS
        
        Moderate: Affects basic ADLs
        
        Severe: Fully dependent
    - - Modest decline in 1+ cognitive domain
      - Does not affect capacity for independence
  - - - 4 Criteria
        
        Acute onset/fluctuating course
        
        Inattention
        
        Disorganized thinking
        
        Altered levels of consciousness
  - - - Amnesia
      - Aphasia, apraxa, agnosia and executive function
      - Progressive
      - Impacts on social/occupational functioning
  - - - Progressive short-term memory loss, and may present with more frequent/noticeable word-finding changes
    - - Mild or major NCD
      - Vascular etiology suggested by : onset of deficits related to CVA, and prominent decline
      - Evidence of CVD
      - Classifications
        
        Large vessel, small vessel, ischemic-hypoperfusive, hemorrhagic
    - - Criteria med for major or mild NCD
      - Insidious onset and gradual progresion
      - 1-2 of the following
        
        Core features (Fluctuating attention, visual hallulcinations, parkinsonian symptoms
        
        Suggestive features (REM, severe neuroleptic
    - - Common in patientets who have passed 5-10 years of parkinson's disease
    - - Behavioural
        
        Frontal lobe demeentia wiht early loss of executive function
      - Language
        
        Severe early expressive aphasia with no obvious cause on neuroimaigng
    - - Brain, Balance, bladder (MRI diagnosis)
- - - - 50% with alzheimers dementia experience persecutory delusions
    - - New onset (delirium), Long standing (lewy body)
- - - - Contraindications
        
        Sinus bradycardia, AV blocks, Fasciular blocks, GI sensitivity, Leg cramps
      - Uses
        
        To slow or temporarily halt the progression of alzheimers
      - Side Effects
    - - Alzheimers: CI + memantine
      - Vasular: Usual risk factor modification
      - Lewy body: Exelon, aricept, Galantamine
      - Parkinson's: Exelon, aricept
      - Frontotemproal;: Avoid CI, SSRI
      - NPH: Shunt