Dementia

DEMENTIA
BRIDGE THE GAP TO YOUR DIAGNOSIS AND MANAGEMENT 

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Did you know this about dementia?

  

Dementia is a name given to a large group of individual disorders of which the classic and most common type is Alzheimers disease. Dementia is characterised by a loss of/impaired higher cognitive functions. Generally speaking, more than one type of cognitive function should be affected to give a diagnosis of dementia. 

Many of us experience transient or reversible alterations in cognition such as walking into a room and forgetting what you were going there for. If this or other changes are consistent, and progressive, perhaps with other symptoms, it may be an opportune time to be assessed.
nurse holding the had of an elder man suffering from dementia
Assessment includes a detailed background. Every assessment has to include a collateral history from somebody who knows you well, because those around the patient see and may give a clearer picture. 

The nuts and bolts of the assessment include a cognitive examination looking at several cognitive domains such as attention, memory, language, calculation, visuospatial function, executive function and praxis. The physical examination of the nervous system is done to look for any associated physical features that appear in disorders such as Lewy Body Dementia, Frontotemporal Dementia, and to identify anything that suggests a structural cause of cognitive change (e.g. growths within the skull vault). 

Many people will not have any evidence of true cognitive dysfunctions once assessed and appropriately investigated. Investigations are also to identify potentially treatable/reversible causes of dementia (e.g. vitamin B12 deficiency, thyroid dysfunction, limbic encephalitis). Treating depression or changing lifestyle may resolve things. 

Follow-up reassessment of those with a single cognitive domain abnormality after a year is helpful, but some may like to go on to have more detailed tests such as lumbar puncture (spinal tap) and PET brain imaging. These may be helpful in prediction of the risk of a true dementia if there is only one area of cognition affected on first assessment. 

For more information on dementia:

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