Dementia

Umer Farooq, MD and Hammad Mohsin, MD Reviewed 06/2020

BASICS

DESCRIPTION

Dementia refers to cognitive decline from previous level of performance in various cognitive domains (attention, executive function perceptual-motor, social cognition, and memory). T...

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

McGuinness B, Craig D, Bullock Ret al. Statins for the prevention of dementia. Cochrane Database Syst Rev. 2009;(2):CD003160. [View Abstract on OvidMedline]

Blass DM, Rabins PV. In t...

ADDITIONAL READING

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

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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