A19. Examination of the patient with dementia

From greek.doctor
  • (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
  • 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