Previous
Diagnosis
Currently, there is no single test that is available to detect and diagnose dementia in clinical practice. Instead the diagnosis of dementia is based on a combination of history taking and physical and neurological exams. Further investigations, such as lab tests and imaging studies, assist to differentiate the types of dementia.
History Taking Tips
build a rapport with the patient and their family/caregivers
obtain information on the time of onset, progression, pattern of decline of cognition and function, family history of dementia etc.
assess problem solving abilities, behavioural changes and psychiatric symptoms
The interviewer must modify her or his style to accommodate the patient being interviewed. For example, if the patient has cognitive deficits, the clinician will need to change the style and extent of history taking and interview to the patient’s capacity while respecting boundaries and preserving patient dignity at all times [1].
Obtain permission to talk with other care providers and the family physician if you not the primary care provider yourself.
For more information on how to conduct a proper patient history, consult the Practical Guide to Clinical Medicine Website.[4]
Examination
In the case of dementia a complete examination includes:
full physical examination, including neurological exam
cognitive assessment including mini mental status examination (MMSE)
For more information on how to conduct full physical and neurological exams, consult the Practical Guide to Clinical Medicine Website[4].
This video reviews the neurological exam in patients with dementia
_________________________________
1. Argonin, Marc E. Dementia Defined. In: Carlat, Daniel J, editor. Practical guides in psychiatry-dementia. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 15-26.
4. University of California, San Diego School of Medicine http://medicine.ucsd.edu/clinicalmed/history.htm accessed: October 4, 2006
