Publication date: Apr 08, 2019
These include learning and memory, use of language, executive functioning (as I tell my patients, this is your ability to juggle life stresses and keep -all the balls in the air”) attention to complex tasks, perceptual motor skills, and the ability to move through the world in a socially acceptable way.
What other kind of neurocognitive conditions can cause dementia symptoms?
Dementia with Lewy bodies, frontotemporal dementia, and dementia that is related to another commonly known illness, Parkinson’s Disease.
Suffice it to say that these last illnesses attack the brain in very specific ways in certain regions, leading to motor functioning and mobility problems, loss of speech, loss of memory, and ultimately the complete inability to take care of oneself.
Many adults that live long enough will have some component of vascular and Alzheimer’s-like dementia symptoms, but not always rising to the level of diagnosis and treatment.
Symptoms of dementia may include forgetfulness, trouble learning and retaining new information, trouble doing complex tasks (see balls in the air above), trouble reasoning, getting lost in space or time (poor orientation), developing problems with language, and behavioral change including out of character or even aggressive or hostile interactions with others.
They can not only give their own historical perspective on changes in the patient, but they can also be a second set of ears as the doctor or other provider gives feedback, schedules testing, or prescribes treatment.
A good longitudinal history of the patient’s interactions and behavior over time is one of the most valuable pieces of the puzzle in diagnosing dementia.
Cognitive testing can run the gamut from a simple screening test like the Mini Mental Status Exam (MMSE), to a mental status at the time of interview to formal multi-hour neuropsychological testing.
If the changes in the history match the mental status examinations and other tests, then there is a high probability that a dementia diagnosis may be made.
Strokes, Parkinson’s Disease, and other medical problems can lead to dementia symptoms.
Back then, we had a list of orders that included labs that we would write any time we admitted someone to the hospital for a dementia workup.
The cognitive changes seen are more than would be expected normally for a given age, but they do not rise to the level of a dementia.
Depressed people will answer -I can’t even try”, while patients with dementia are happy to try to give answers, but they are all incorrect.