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Dementia, Emergency Medicine

Gabriel Wardi Reviewed 06/2017
 


Basics

Description

  • Progressive deterioration in cognition, behavior, or both without impaired consciousness that is severe enough to interfere with activities of daily living due to alteration in corti...

Diagnosis

Signs and Symptoms

  • Insidious onset, with initial complaints of anxiety, depression, frustration, increased forgetfulness

  • Generally preceded by “mild cognitive impairment,” an intermediate stat...

Treatment

Pre-Hospital

  • Obtain history from friends, family

  • Provide for patient and staff safety

  • Manage agitation

  • Attentiveness to comorbid conditions

  • Treat acute toxic and metabolic disorders:

    • Hypoglycemia

    • H...

Follow-Up

Disposition

Admission Criteria

  • Unstable vital signs

  • Significant comorbid condition requiring parenteral medications:

    • Pneumonia

    • UTI

    • Fluid and electrolyte disorder

  • Uncertain diagnosis requiring evalu...

Pearls and Pitfalls

  • Primary dementia is characterized by slow, steady progression:

    • Course is generally 5–10 yr from diagnosis to death.

  • Can fluctuate as consequence of intervening illness and comorbid c...

Additional Reading

  • Holsinger  T, Deveau  J, Boustani  M, et al. Does this patient have dementia? JAMA.  2007;297:2391–2404.

  • Langa  KM, Foster  NL, Larson  EB. Mixed dementia: Emerging concepts and...

Codes

ICD9

  • 294.10 Dementia in conditions classified elsewhere without behavioral disturbance

  • 294.20 Dementia, unspecified, without behavioral disturbance

  • 331.0 Alzheimer's disease

  • 294.21 Dementia, unspeci...

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