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Cognitive Impairment in Older Adults - Coggle Diagram
Cognitive Impairment in Older Adults
Depression
Risk Factors
Female
Widowed/divorced
Hx of depression
Medications
Physical/chronic illness
Screening Tools & Investigations
PHQ-2
PHQ-9
GDS-15
Cornell Scale for Depression in Dementia
Presentation
Insidious Onset
Normal LOC
Normal Orientation
Normal attention (may be altered)
Organized thought process unless severe case where it may be disorganized
May present with psychosis or delusion
Normal speech but can be slow
Lethargic
Management
Medications
Therapy
Cognitive behavioural
Life review therapy
Diagnostic Criteria
Depressed mood,
Sleep difficulties
Loss of interest
Appetite disturbance
Fatigue/ loss of energy
Dementia
Screening Tools and Investigation
MMSE
Mini-Cog
RUDAS
Risk Factors
Family History
Age
Low Education
Hearing Loss
Brain Injury
Diet and Physical Inactivity
Diagnostic Criteria
Evidence of significant cognitive decline one or more cognitive domains
Cognitive deficits interfere with independence in everyday activities
Cognitive deficits do not occur exclusively in the context of delirium
Cognitive deficits are not better explained by another mental disorder
Presentation
Confusion
Memory Loss
Poor Judgment
Management
Cholinesterase Inhibitors
NMDA receptor antagonists
Lifestyle: exercise, mediterranean diet
Community Resources
Delirium
Screening Tools & Investigations
Delirium Observation Screening Scale (DOS)
Nursing Delirium Screening Scale (Nu-DESC)
Confusion Assessment Method (CAM)
Memorial Delirium Assessment Scale (MDAS)
Risk Factors
CVD
Medications
Sleep deprivation
Hospitlization/infection
Presentation
Acute Onset
LOC, can be fluctuating, somnolent or hyperactivity
Fluctuating Speech (incoherent or rambling)
Disorganized and Chaotic thought process
May present with hallucinations or delusions
Agitated state
Diagnostic Criteria
Acute change in Mental Status
Inattention
Disorganized thinking
Altered Level of Conciousness
Management
Medication cessation
Treatment of infection
Treat pain
Address incontinence
Include family in care
Avoid changes in environment
Mild Cognitive Impairment
MoCA (**sensitive for mild cognitive impairment)
Early stage of memory and cognitive ability loss