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| Overview of Dementia |
| Diagnostic Criteria for Dementia |
 | Impaired social or occupational function |
| Impaired memory, plus
one or more area of the following cognitive functions
 | Abstract/problem solving |
| Judgment |
| Language |
| Personality |
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| Clear consciousness |
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| Differentiate Depression from Dementia
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| Depression |
Dementia |
| Relatively rapid onset |
| Depressive symptoms start before dementia |
| Patient complains more than family |
| Appears depressed |
| Response of "I don't know" |
| Inconsistent Cognitive impairment |
| Response to antidepressant |
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| very slow onset |
| depressive symptoms develop
after cognitive decline |
| Patient tends to deny any memory problem |
| May or may not appear depressed |
| Try to give an excuse or general answer |
| Cognitive impairment fairly consistent |
| Antidepressant may have no effect |
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| Causes of Dementia |
| Alzheimer's dementia |
| Multiinfarct dementia |
Normal Pressure Hydrocephalus
| 3 main symptoms: Dementia, Gait Apraxia, Incontinence |
| Language functions preserved |
| Most common cause of gait abnormality plus Dementia is multiinfarct
dementia |
| May progress over months to years then reach a plateau |
| MRI shows large ventricles |
| LP may result in temporary improvement |
| Treatment is VP or LP shunt |
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HIV dementia
| Younger patient |
| Memory loss |
| Frontal lobe dysfunction, personality change, social withdraw |
| Progresses over months |
| May be the initial presentation of AIDS |
| May have other brain infection/tumor |
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Other causes of Dementia
| Toxic/Metabolic/Nutritional:
| Alcohol or drugs, Vitamin deficiencies, Hormonal
disturbances. |
| More likely to have change in level of consciousness |
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| Primary progressive Aphasia:
| progressive aphasia without true dementia |
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| Jacob Creutzfeld Disease:
| progressive dementia with seizures, myoclonus, ataxia, visual
disturbance, motor neuron dysfunction |
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| Chronic infections, vasculitis:
| Cryptococcal, fungal. |
| Progressive multifocal leukoencephalopathy |
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| Bilateral Subdural hematoma |
| Brain tumor: especially frontal glioma |
| Neurodegenerative Disorders
| Parkinson's disease |
| Lewy body dementia |
| Progressive supranuclear palsy |
| Frontotemporal dementias (e.g., Pick's disease, primary progressive
aphasias) |
| Cortical-basal degeneration |
| Hippocampal sclerosis |
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Return to degenerative disease info center
Differentiate Pseudodementia & Dementia
Alzheimer's dementia
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