A19. Examination of the patient with dementia
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- (No good source, uncertain what it important)
- History
- An informant who knows the patient well should be present
- When did the informant first notice memory loss?
- How has the memory loss progressed since then?
- Recent changes in personality or mood?
- Drugs
- Opioids
- Anticholinergics
- Antidepressants
- Sedatohypnotics (benzos, etc.)
- Which daily activities can the patient perform now compared to previously?
- Medical history
- Stroke/TIA
- Cardiovascular disease
- Diabetes
- Alcohol use
- Sleep status
- Other neurological symptoms
- Loss of vision
- Loss of motor function
- Tremor
- Poor balance and falls
- Incontinence
- An informant who knows the patient well should be present
- Cognitive testing
- MMSE (mini mental state examination)
- WAIS (Wechsler adult intelligence scale)
- Laboratory examination
- B12 deficiency
- Thyroid status
- Imaging
- In cases of acute neurologic deterioration
- Head CT or MRI
- Neurological physical examination
- Examination for frontal release signs
- See topic 54
- Ocular examination (topics 2 and 3)
- Examination of gait
- Examination of extrapyramidal symptoms
- Bradykinesia, rigidity, dystonia, akathisia, etc.
- -> Dementia with Lewy bodies, Parkinson, vascular dementia, etc.
- Examination of pyramidal signs
- -> motor neuron disease
- Examination of fundus
- Papilloedema -> tumour, hydrocephalus
- Examination for frontal release signs