AD, however, remains the most common dementia even in younger people, followed by vascular dementia and frontotemporal lobar degenerations. The age of the patient is important as dementia in the young has a different aetiological profile than that seen in the elderly. Important features to note in the history include: Delirium as opposed to dementia should be considered if the patient appears poorly responsive. If alertness is decreased, causes of this should be sought-for example, by a careful scrutiny of the drug history. The level of alertness and cooperation during the interview should be assessed. The meaning of unusual or infrequently used words may be lost. Semantic memory breakdown may manifest as a diminution of vocabulary with words being substituted by вЂњthingвЂќ. Anterograde memory deficiencies are suggested by the losing of objects, repetitive questioning, difficulty taking messages, an increasing reliance on lists, the failure to follow plots of films or television programmes, and getting lost (navigation).

Difficulties with specific aspects of memory are suggested by certain problems encountered in day to day activities. Documentation of specific examples is a useful way of providing information that can be utilised by subsequent clinicians. The presence of word finding difficulties, paraphasic errors, and inappropriate behaviour is helpful in determining the likely cause of the dementia. Conversation with the patient may be as important as any formal cognitive assessment.

It also allows an assessment into the degree of insight of the affected individual. Interviewing the patient separately enables the cooperation and language skills to be assessed without them being masked by interruptions or assistance from a third party. The absence of a concerned relative or friend at the appointment may lessen the likelihood of dementia in a patient complaining of memory problems. It is useful to interview the patient and the accompanying person separately. The need to physically examine the patient, looking for signs pointing to a particular cause, is discussed below. It is vital to obtain a corroborating history from a relative or close friend in addition to the patientвЂ™s account if they can provide one. TAKING A HISTORY AND THE EXAMINATION OF THE MEMORY IMPAIRED PATIENT Certain investigations are mandatory and additional tests are recommended if the history and examination indicate particular aetiologies. A focused cognitive and physical examination is useful and the presence of specific features may aid in diagnosis. Clues to the nature and aetiology of the disorder are often found following careful consultation with the patient and carer.

When approaching the patient with a possible dementia, taking a careful history is paramount. It is important to exclude delirium when considering such a diagnosis. To be significant the impairments should be severe enough to cause problems with social and occupational functioning and the decline must have occurred from a previously higher level. When making a diagnosis of dementia, features to look for include memory impairment and at least one of the following: aphasia, apraxia, agnosia and/or disturbances in executive functioning. Dementia is a clinical state characterised by a loss of function in at least two cognitive domains.

Do i have amnesia quiz