بسم الله الرحمن الرحیم. dementia dementia is a condition characterised by a...
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بسم اللهالرحمن الرحیم
DementiaDementia is a condition characterised by a
progressive decline of mental abilities accompanied by changes in personality and behaviour.
There is a loss of memory and skills that are needed to carry out everyday activities.
Dementia is a complex syndrome
Psychological / psychiatric symptoms
Behavioral
Behavioral disturbances
Amnesia ApraxiaAgnosiaAphasia
Functional
Cognitive
Instrumental ADL Personal ADL
Differential diagnosis :1- functional Disorders:
2-Other Dementias
3-Medical (NPH)……..4-Delirium5-MCIMedical (NPH)……..
Differential diagnosisFunctional :Mania ,hypomania (in the most patientsThe symptoms and signs of functional illness
are clear)Cognitive impairment ccurs in 40-60 percent
of symptomatic bipolar elderlyAttention ,executive function and memoryPoor prognosis, prodrome of dementia
Differential diagnosis
Functional:Schizophrenia( early onset and late onset)Rarly very late onst sch. cognitive symptoms increase than
normal aging
Differential diagnosis Functional :
depression DePression with reversible dementia
Isolation ,memory loss, ……
prodrome of dementia(20 percent per yer)
9
Differential diagnosis :depression
OnsetResponseRisk factorsFhOther symptoms
Differential diagnosisDepression –executive dysfunction
syndrome (damage to frontostriatal circuits)
executive dysfunction,psychomotor retardation reduced interest in activities and response to antidepresants
Differential diagnosis2-Other Dementias: Vascular dementia (10-20 percent of theOld age dementia)Frontotemporal dementia
Lewy body dementia
Acute onsetStepwise
Risk factorsGait
Neurological
Gradual onsetMemory loss
Normal examination
HallucinationsFluctuationsVisuospatial
Parkinsonism
BehaviouralLanguageFamily hx
Young onset
Vascular Dementia
Alzheimer’sDisease
Lewy Body Dementia
Frontotemporalal Dementia
Medical NPH
Endocrine: hypothroidism,cushing
Tumour, Toxin, Trauma
Infection, Immunologic,
Drugs;anticholinergic agents
Metabolic
Nutritional
Mild Cognitive Impairmentfunctioning well and do not meet clinical criteria
for dementia atients who are memory impaired but are otherwise are classified as having MCI
Symptoms includeMemory complaintObjective memory impairmentNormal general cognitive functionIntact activities of daily livingNot demented
Patients with MCI should be recognized and monitored for cognitive and functional decline due to their increased risk for subsequent dementia
deliriumSyndrome of :Disturbed consciousness ,cognition and with
perception and behavioral symptomsAcute onsetFlactuative courseHistory for dementiaSubtypes:hyperactive and hypoactive
Dementia ?Reversible causes ?
Depression ?Delirium ?
MCI ??
Acute onsetStepwise
Risk factorsGait
Neurological
Gradual onsetMemory loss
Normal examination
HallucinationsFluctuationsVisuospatial
Parkinsonism
BehaviouralLanguageFamily hx
Young onset
Frontotemporal Dementia
Lewy Body Dementia
Alzheimer’sDisease
Vascular Dementia
:وبه طور خالصه:شرح حال در زمینه موارد زیرنحوه شروع عالیم،حاد یا تدریجیتغییرات در طول زمان سابقه خانوادگیریسک فاکتورهابیماریهای زمینه ایعالیم همراهسایکوموتور
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