Jack Twersky, MDJack Twersky, MDMedical Director CLC DurhamMedical Director CLC Durham

Memory impairment and at least one of Memory impairment and at least one of the followingthe following AphasiaAphasia ApraxiaApraxia AgnosiaAgnosia Executive functionExecutive function

ImpairmentImpairment DeclineDecline DeliriumDelirium

Common DementiasCommon Dementias Alzheimer DiseaseAlzheimer Disease Lewy Body DementiaLewy Body Dementia Vascular DementiaVascular Dementia Mixed DementiaMixed Dementia Frontotemporal Frontotemporal

DementiaDementia Parkinson DiseaseParkinson Disease

Less Common Less Common DementiasDementias

Alcohol Related Alcohol Related DementiasDementias

Traumatic Brain InjuryTraumatic Brain Injury Normal Pressure Normal Pressure

Hydrocephalus*Hydrocephalus* Brain tumorBrain tumor Paraneoplastic Paraneoplastic

SyndromeSyndrome Cancer TreatmentCancer Treatment Huntington DiseaseHuntington Disease Progressive Progressive

Supranuclear Palsy Supranuclear Palsy

Early stage- Early stage- gradual memory loss. gradual memory loss. language errors, impaired IADLs, language errors, impaired IADLs, worsening visual spatial-perceptionworsening visual spatial-perception

Middle stage- Middle stage- apraxia, disorientation, apraxia, disorientation, impaired judgmentimpaired judgment

Advanced stage- Advanced stage- dependent in ADLs, dependent in ADLs, loss of ability to ambulate and swallowloss of ability to ambulate and swallow

DementiaDementia Visual hallucinationsVisual hallucinations ParkinsonismParkinsonism Cognitive fluctuationsCognitive fluctuations DysautonomiaDysautonomia Sleep disordersSleep disorders Neuroleptic sensitivityNeuroleptic sensitivity

Dementia Dementia Cerebrovascular diseaseCerebrovascular disease

presence of focal signs on neurologic presence of focal signs on neurologic examination, examination,

evidence of relevant CVD by brain imaging (CT or evidence of relevant CVD by brain imaging (CT or MRI) MRI)

+ Relationship between the two• onset of dementia within three months following a onset of dementia within three months following a

strokestroke• abrupt deterioration in cognitive function or abrupt deterioration in cognitive function or

stepwise progression of cognitive deficits.stepwise progression of cognitive deficits.

Insidious onset and gradual Insidious onset and gradual progressionprogression

Early decline in social interpersonal Early decline in social interpersonal conductconduct

Early impairment in regulation of Early impairment in regulation of personal conductpersonal conduct

Early emotional bluntingEarly emotional blunting Early loss of insight Early loss of insight