Dementia Workup and Diagnosis of Cognitive Declin Dr Troye Wallett - PowerPoint PPT Presentation

Dementia Workup and Diagnosis of Cognitive Declin Dr Troye Wallett

DSM V Criteria For Dementia Minor Neurocognitive Disorder (previously Mild Cognitive Impairment) Modest cognitive decline from baseline. No effect on activities of daily living but may have compensatory mechanisms to cope . Major Neurocognitive Disorder (previously Dementia) Significant cognitive decline from baseline that effects the person’s activities of daily living. Both the above are not delirium or another psychiatric disorder.

Dementia Definition A progressive, global life-limiting condition that involves generalised brain degeneration that effects people in different ways and has different forms.

Questions?

The Work up of Cognitive Decline

Kevin, Aged 88 Table Discussion. • Fall off his ladder • Hit his head and CT normal What is your Differential • Apathetic since fall • Memory loss since fall Diagnosis? What focused points on history and examination PMH: Medications: Diabetes – well controlled would help distinguish Metformin 1g BD Hypertension Atorvastatin 40mgs OD Osteoarthritis Perindopril 4mgs OD between the differentials. GORD Temazepam 10mgs Nocte Benign Prostatic Hypertrophy Aspirin 100mgs OD

Dementia Pneumonic D - Drugs E - Ears and Eyes: Many people’s cognition improves when they can hear. M - Metabolic: Hyper or Hyponatremia Calcium imbalance Thyroid, Urea E - Emotions: Depression manifesting as cognitive decline N - Nutritional: Tea and toast oldes, pellagra, Vit B12 deficiency, T - Trauma or tumor - A small knock on the head causing a slow subdural. I - Infection: Our favourite UTI and others A - Alcohol, Alzhemiers or atherosclerosis: CVAs

How do you know it is Dementia?

Cognitive Decline Investigations • FBC • U&E • LFTs • TFTs • Vit B12 and folate • CT scan if appropriate • ?syphilis serology • ?HIV • CXR, Urine (depending on clinical assessment)

Questions?

What have we learned Cognitive Decline is dementia until proven otherwise. History, examination and investigations will exclude other causes.

Keep in Touch https://www.linkedin.com/in/troyewallett/ www.troyewallett.com t.wallett@genwisehealth.com.au For all the resources go to www.genwisehealth.com.au/dementiaresources