Dementia resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.
Overview
Dementia is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging, it should be disoriented from delirium which involves an acute onset, and usually is reversible. Dementia may affect several cognitive areas, such as memory, attention, language, and problem-solving. In advanced stages of the condition, affected persons may be disoriented in time, place, and/or in person. The diagnosis of dementia is primarily clinical and ruling-out other conditions by imaging and laboratory tests. It is important to always screen for depression, especially in older people, since this may be the underlying problem.
Life Threatening Causes
There are no identified life-threatening causes in dementia that may lead to death within 24 hours since all conditions are chronic.
Common Causes
- Alzheimer's Disease
- Parkinson's Disease
- Binswanger's Disease
- Dementia with Lewy bodies
- Thiamine deficiency
- Vascular dementia
- Marijuana abuse
- AIDS
- Neurosyphilis
- Normal pressure hydrocephalus
- Vitamin B12 deficiency
- Vitamin B6 deficiency
Diagnosis
Shown below is an algorithm summarizing the diagnosis of amnesia according to the the American Academy of Neurology guidelines:[1]
| Progressive decline in cognitive function with chronic onset | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Severe disimpairment in social functioning? | No | Normal aging | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Dementia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Measure vitamin B12, and folate, and TSH | Abnormal? | Yes | Vitamin deficiency, hypothyroidism | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive for SIGE CAPS questionary? | Yes | Depression | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Take history and perform physical examination | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Initial short term memory loss | Vascular risk factors, imaging evidence of cerebrovascular involvement | Young age, behavioral symptoms or language impairment | Bradikinesia or features of parkinsonism,
fluctuating cognition, [[visual hallucinations]] | Dementia occuring 1 year after onset of Parkinson disease | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Alzheimer disease | Vascular dementia | Frontotemporal dementia | Dementia with Lewy bodies | Parkinson disease dementia | |||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References