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

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

Nov 20, 2023 171 likes •310 views

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

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Dementia

Workup and Diagnosis of Cognitive Declin

Dr Troye Wallett

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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.

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Dementia Definition

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

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Questions?

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The Work up of Cognitive Decline

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Kevin, Aged 88

  • Fall off his ladder
  • Hit his head and CT normal
  • Apathetic since fall
  • Memory loss since fall

PMH:

Diabetes – well controlled Hypertension Osteoarthritis GORD Benign Prostatic Hypertrophy

Medications:

Metformin 1g BD Atorvastatin 40mgs OD Perindopril 4mgs OD Temazepam 10mgs Nocte Aspirin 100mgs OD

Table Discussion. What is your Differential Diagnosis? What focused points on history and examination would help distinguish between the differentials.

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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

Dementia Pneumonic

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How do you know it is Dementia?

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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)

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Questions?

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What have we learned

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

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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