27. Diagnostic criteria of dementia

Question 1

History taking in diagnosis of dementia

Answer 1

1. Patient history of cognitive and behavioural changes
2. Drug history
3. Depression screeing (rule out pseudodementia)

Question 2

What is mini-mental state examination

Answer 2

Screening tool assessing degree of cognitive impairment in individuals with suspected dementia. Scoring < 20 points = dementia

Question 3

Parts of the mini-mental state examination

Answer 3

• Orientation of time: what day is it?
• Orientation of space: where are we?
• Short-term memory: please repeat after me: “lemon”
• Attention/concentration: count backward from 100
• Repeat: repeat the word previously mentioned

Language:
- What is this – pointing at an object
- Can you write a sentence
- Copy this figure

Question 4

Definition of dementia according to DSM-5

Answer 4

Significant cognitive decline in one/more of language, memory, attention, social cognition, executive function, perceptual-motor. The cognitive deficit interfere with everyday life and can not be explained by another mental disorder.

Question 5

Clock drawing test

Answer 5

Pt. given sheet with empty circles on it, and asked to draw a clock. Already bad results in early dementia.

Question 6

Lab tests for dementia

Answer 6

For all patients: vitamin B12 and hypothyroidism tests
For pt. with rapid dementia, young etc.:
- Serum electrolytes
- Renal- and liver FT
- Ceruplasmin (decr. in wilsons, can cause sympt. of dementia)
- ApoE genotyping

Question 7

Imaging in dementia

Answer 7

In all pt.: non-contrast CT/MRI
Special: PET, SPECT, EEG

Question 8

List parts of diagnostic tools of dementia

Answer 8

1. History taking
2. Examination (neuro, phys.)
3. Mini-mental state examination
4. Clock-drawing test
5. Labs
6. Imaging
7. DSM-V criteria