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Dementia

Umer Farooq, MD and John Doyle, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • DSM-5 classifies dementias under neurocognitive disorders (major and mild).

  • Evidence of cognitive decline from previous level of performance in one of cognitive domains (attention, ex...

DIAGNOSIS

HISTORY

Probable diagnosis AD (2): 
  • Age between 40 and 90 years (usually >65 years)

  • Progressive cognitive decline of insidious onset

  • No disturbances of consciousness

  • Deficits in areas of cogni...

TREATMENT

GENERAL MEASURES

  • Daily schedules and written directions

  • Emphasis on nutrition, personal hygiene, accident-proofing the home, safety issues, sleep hygiene, and supervision

  • Socialization (adult d...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Progression of cognitive impairment by use of standardized tool (e.g., MMSE, ADAS-Cog)

  • Development of behavioral problems: sleep, depression, psy...

REFERENCES

1
McGuinness B, Craig D, Bullock R, et al. Statins for the prevention of dementia. Cochrane Database Syst Rev.  2009;(2):CD003160. [View Abstract on OvidMedline]
2
Blass DM, Rabins PV. In...

ADDITIONAL READING

Lyketsos CG, Colenda CC, Beck C, et al; for Task Force of American Association for Geriatric Psychiatry. Position statement of the American Association for Geriatric Psychiatry rega...

CODES

ICD10

  • F03 Unspecified dementia

  • G30.9 Alzheimer’s disease, unspecified

  • F01.50 Vascular dementia without behavioral disturbance

  • G31.83 Dementia with Lewy bodies

ICD9

  • 331.0 Alzheimer’s disease

  • 290.40 Vasc...

CLINICAL PEARLS

  • Medications for AD show a small, statistically significant improvement in some cognitive measures, but it remains unclear if the improvement is clinically significant.

  • Do not forget the...

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