Dementia and Loss of memory Describe what happens When did this start Does it come and go or is always there? If yes, how often does it happen and how long does it last for? How has this changed over time? Have they had anything like this before? Is it fluctuating? Can they think of what might have caused it? How has it been affecting their life? Does anything make it worse? Does anything make it better? Have you gotten lost? Do they need help any with daily tasks> Associated features: Personality changes Change in eating patterns Unable to control anger and quick to anger Overreactions Inappropriate situational reactions. Lack of motivations and low interests Sits still for hours and does not move Difficulty in reasoning and problem solving Difficulty in planning Sleep disturbances Visual hallucinations Poor concentration Tremors Hunched back Mask face Tingling Weakness Issues walking and falls Urinary issues Suicidal thoughts Dry hair and skin Cold intolerance Assessment of daily activities of living: Instrumental -> activities of independent living: Cleaning, financing, transport, cooking tec. Personal -> self-care Toilet, showering, grooming, eating etc. Domestic -> leisure activities First to be lost Medications Prescription Non-prescription Past medical history Especially strokes Allergies and vaccinations Surgeries Family history Social history Diet Smoking Alcohol Recreational drugs Living situations Support systems Exercise Work Examinations Mental status Neurological Thyroid examination Differentials Frontotemporal dementia: Personality change Lack of insights Loss of social awareness. Change in eating patterns Emotional blunting Mental rigidity Attention deficient Orbitofrontal -> IMPULSE CONTROL Abnormal impulse control Impulsive Quick to anger Unable to control emotions Make rude and childish remarks. Loss of insight Narcissistic Overly reactive Poor situational awareness Inability to ignore irrelevant stimuli Mediofrontal -> LACK OF MOTIVATION AND MOVEMENT May sit motionless for hours. May be mute for hours. Urinary and bowel incontinence Leg weakness Dorsolateral -> PLANNING AND REASONING Difficulty in reasoning Difficulty in problem solving Shift attention Difficulty in maintaining behaviour for task completion -> persistence. Vascular Stroke Parkison disease Mask face Loss of emotions Hatched back Normal language Impaired visuospatial function. Lewy body dementia Fluctuating REM sleep disorders Recurrent visual hallucinations. Alzheimer’s disease Insidious onset Slow progression Episodic memory affected first Language impairment Executive function impairment Progressive aphasia Apraxia Alexia Agnosia Acalculia Apathy Normal pressure hydrocephalus Classical triad of: Gait abnormalities Dementia Urinary incontinence