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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