Assessment of Dementia in the ED

Authors: Helen Mansfield / Editors: Michael John Stewart / Reviewers: Jennifer Lockwood, Amanda King / Codes: A5 / Published: 08/01/2021

Learning Objectives

Describe the basic pathophysiological mechanisms of the common forms of dementia
Identify the key clinical distinctions between the common forms of dementia
List examples of common errors in the assessment of dementia patients presenting to the ED
Describe a pragmatic but systematic method of assessment of dementia patients which adequately differentiates between non-reversible disease progression and reversible co-morbidities
Explain the commonly used and accessed interventions and support agencies for patients with dementia and their carers

START MODULE

References:

Mini Mental State Examination.
6-item Cognitive Impairment Test (6-CIT)
The General Practitioner Assessment of Cognition (GPCOG)
Test Your Memory
MATTHEWS, F. and BRAYNE, C. (2005) The Incidence of Dementia in England and Wales: Findings from the Five Identical Sites of the MRC CFA Study, PLoS Medicine, 2(8)e, pp. 193 1-11.
National Institute for Health and Clinical Excellence (NICE) (2006) Dementia. The NICE-SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care. London; National Institute for Health and Clinical Excellence, November 2006.
McGUINNES, B. et al. (2006) Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD004034. DOI: 10.1002/14651858.CD004034.pub2.
HOGERVORST, E. et al. (2009) Hormone replacement therapy to maintain cognitive function in women with dementia. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD003799. DOI:10.1002/14651858.CD003799.pub2.
GUY, M. et al. (2001) Clinical and Pathological Diagnosis of Frontotemporal Dementia Arch Neurol, 58, pp. 1803-1809.
DUBIOS, B., et al. (2007) Research Criteria for the Diagnosis of Alzheimers Disease; revising the NINCDS-ARDA criteria. Lancet Neurology, 6(8), pp. 734-746.
FERREIRA, S.T. et al. (2007) Soluble protein oligomers as emerging toxins in Alzheimer’s and other amyloid diseases. IUBMB life, 59 (4-5), pp. 332345.
McKEITH, I.G. et al. (1996) Consensus Guidelines for the Clinical and Pathological Diagnosis of Dementia with Lewy bodies (DLB) Neurology, 47, pp. 1113-1124.
McKHANN, G. et al. (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34, (7) pp. 939944.
ROMAN, G.C. et al. (1993) Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43(2), pp. 250-260.
KNOPMAN, D.S. et al. (2001) Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, pp. 11431153.
GOLD, G. et al. (2002) Clinicopathological validation study of four sets of clinical criteria for vascular dementia. The American Journal of Psychiatry, 159, pp. 8287.
McKEITH, I.G. et al. (2000) Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology, 54, pp. 10501058.
Dorlands Illustrated Medical Dictionary. Edition 28. (1994) Philadelphia, W.B. Saunders Company.
ARNOLD, E. (2004) Sorting Out the 3 Ds: Delirium, Dementia and Depression. Nursing, 34(6), pp. 36-42.
FOLSTEIN, M.F. et al. (1975) Mini Mental State a Practical Guide for Grading the Cognitive State of Patients for the Clinician. J Psychiatry Res, 12(2), pp. 189-198.
KATZMAN R. et al. (1983) Validation of a Short Orientation-Memory-Concentration Test of Cognitive Impairment. Am J Psychiatry, 140(6), pp. 734-739.
BRODATY, H. Et al. (2002) The GPCOG: a New Screening Test for Dementia Designed for General Practice J Am Geriatr Soc, 50, pp. 530-534.
SOLOMON, P. and PENDLEBURY, W. (1998) Recognition of Alzheimers Disease: the 7 Minute Screen. Fam Med, 30(4), pp. 265-271.
CARPENTER, C. Does (2008) Does This Patient Have Dementia? Ann Emerg Med 52 pp. 554-556