DR Medhat MRCP

Dementia
dfs adasd dhe
• Def : - Progressive & irreversible clinical syndrome that is characterized by global
deterioration in intellectual function, behaviour and personality in the presence
of normal consciousness and perception.
• Risk factors :
Non-modifiable risk factors :
1. Old age (most important).
2. Learning disabilities e.g Down`s syndrome.
3. Female sex.
4. Genitic predisposition.
Modifiable risk factors :
1. Alcohol consumption.
2. Smooking ; particulary for Alzheimer.
3. Obesity.
4. 3H : HTN ,Hypercholesterolemia & Head injury.
• Causes :
1. Alzheimer's disease : the most common cause of dementia in UK (60%).
2. Vascular & Lewy body dementia: 2 nd common cause in UK (15-20%).
3. Mixed cases : (Alzheimer + vascular D. or Alzheimer + Lewy body D.).
4. frontotemporal dementia (FTD) : in young age.
5. Others : e.g hypothyroidism,normal pressure hydrocephalus,multi-infarcts,tumors
• Features(diagnosis):
Diagnosis can be difficult and is often delayed, it`s mainly clinical diagnosis.
The mini-mental state examination(MMSE) is widely used: A score of ≤ 24 out of
30 suggests dementia.
MMSE : is a brief 30-point questionnaire test that is used to screen for cognitive
Impairment.
Category
Points
Orientation to time 5
Orientation to place 5
Registration(repeating named prompts) 3
Attention and calculation(serial sevens) 5
Recall (registration recall) 3
Language (naming a pencil & watch) 2
Repetition(Speaking back a phrase) 1
Complex commands (drawing figure shown) 6
Total score 30
72