Young Onset Dementia-Initial Assessment

8/6/2019 Young Onset Dementia-Initial Assessment

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Young Onset Dementia- Initial Assessment

Presenting Problems

1 Memory related

2 Language related

3 Behavioural problems

4 Neurological Disorder

5 Basic ADLs

6 Instrumental ADLs

7

8

9

Vascular Risk factors

1 Diabetes Mellitus

2 Hypertension

3 Hypercholesterolemia

4 Smoking

5 h/o TIA

6 h/o CVA

7 Peripheral vascular Disease

8 Atrial Fibrillation

9 Valvular Heart Disease

10

11

12


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Neurological Problems

Parkinsons disease

Huntingtons disease

Multiple Sclerosis

Motor Neuron Disease

Progressive Supra Nuclear Palsy

CVA

Restless Leg Syndrome

Heavy metal Exposure

Hazardous occupation

Traumatic Brain Injury Mild, Moderate, Severe When? H/o hospitalisation, current support

network, previous cognitive assessment, medico legal /claims outstanding

Others

OTHER MEDICAL DISORDERS

Disorder Duration

MEDICATIONS

MEDICATION DOSE

1

2

34


3/8

5

6

7

8

9

1011

12

Alcohol History

How many years

Typical drinking pattern

Binging or continuous drinking

Average drinks per dayNo of Units per week

Worst day

Withdrawal features

Tolerance

Physical complications cirrhosis, jaundice, peptic ulcer disease ,peripheral neuropathy,freq falls

Psychological complications

Inability to control

Period of abstinence if any

Psychiatric History

Psychosis

Depression

Anxiety Disorder

Bipolar Disorder

Alcohol/drug misuse

Personality Disorder

Others

Treatment received /receiving for any of the above

Current Psychiatric problems

1. Depression BDI, HADS, history +MSE

2. Psychosis BPRS, history +MSE

3. Anxiety Disorder HADS, history +MSE

4. Others - history +MSE


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Katz Index of Independence in Activities of DailyLiving

Activities

Points (1 or 0)

Independence

(1 Point)NO supervision, direction or

personal assistance

Dependence

(0 Points)WITH supervision, direction,

personal assistance or total

care

BATHING

Points: __________

(1 POINT) Bathes self

completely or needs help in

bathing only a single part of

the body such as the back,

genital area or disabled

extremity

(0 POINTS) Need help with

bathing more than one part of

the body, getting in or out of

the tub or shower. Requires

total bathing

DRESSING

Points: __________

(1 POINT) Get clothes from

closets and drawers and putson clothes and outer garments

complete with fasteners. May

have help tying shoes.

(0 POINTS) Needs help with

dressing self or needs to becompletely dressed.

TOILETING

Points: __________

(1 POINT) Goes to toilet, gets

on and off, arranges clothes,

cleans genital area without

help.

(0 POINTS) Needs help

transferring to the toilet,

cleaning self or uses bedpan

or commode.

TRANSFERRING

Points: __________

(1 POINT) Moves in and out

of bed or chair unassisted.

Mechanical transfer aids are

acceptable

(0 POINTS)Needs help in

moving from bed to chair or

requires a complete transfer.

CONTINENCE

Points: __________

(1 POINT) Exercises

complete self control over

urination and defecation.

(0 POINTS) Is partially or

totally incontinent of bowel or

bladder

FEEDING

Points: __________

(1 POINT) Gets food from

plate into mouth without help.

Preparation of food may be

done by another person.

(0 POINTS) Needs partial or

total help with feeding or

requires parenteral feeding.

Total Points: ________

Score of 6 = High, Patient is independent.

Score of 0 = Low, patient is very dependent.


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INSTRUMENTAL ACTIVITIES OF DAILY LIVING

SCALE (I.A.D.L.)


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Hospital Anxiety and Depression Scale (HADS)

Patients are asked to choose one response from the four given for each interview.

They should give an immediate response and be dissuaded from thinking too longabout their answers. The questions relating to anxiety are marked "A", and todepression "D". The score for each answer is given in the right column. Instructthe patient to answer how it currently describes their feelings.

A I feel tense or 'wound up':

Most of the time 3

A lot of the time 2

From time to time, occasionally 1

Not at all 0

AI get a sort of frightened feelingas if something awful is about tohappen:

Very definitely and quite badly 3

Yes, but not too badly 2

A little, but it doesn't worry me 1

Not at all 0

DI can laugh and see the funnyside of things:

As much as I always could 0

Not quite so much now 1

Definitely not so much now 2

Not at all 3

AWorrying thoughts go throughmy mind:

A great deal of the time 3

A lot of the time 2

From time to time, but not toooften

1

Only occasionally 0

D I feel cheerful:

Not at all 3

Not often 2

Sometimes 1

Most of the time 0


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AI can sit at ease and feelrelaxed:

Definitely 0

Usually 1

Not Often 2

Not at all 3

D I feel as if I am slowed down:

Nearly all the time 3

Very often 2

Sometimes 1

Not at all 0

AI get a sort of frightened feeling

like 'butterflies' in the stomach:

Not at all 0

Occasionally 1

Quite Often 2

Very Often 3

DI have lost interest in myappearance:

Definitely 3

I don't take as much care as I

should2

I may not take quite as much care 1

I take just as much care as ever 0

AI feel restless as I have to be onthe move:

Very much indeed 3

Quite a lot 2

Not very much 1

Not at all 0

DI look forward with enjoyment tothings:

As much as I ever did 0

Rather less than I used to 1

Definitely less than I used to 2

Hardly at all 3


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Scoring (add the As = Anxiety.Add the Ds = Depression). Thenorms below will give you an ideaof the level of Anxiety andDepression.

0-7 = Normal

8-10 = Borderline abnormal

11-21 = Abnormal

Reference:

Zigmond and Snaith (1983)

A I get sudden feelings of panic:

Very often indeed 3

Quite often 2

Not very often 1

Not at all 0

DI can enjoy a good book or radioor TV program:

Often 0

Sometimes 1

Not often 2

Very seldom 3

Young Onset Dementia-Initial Assessment

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