Dementia Definition Significant cognitive impairment in at least ONE of: Learning and memory Language Executive dysfunction Complex attention Perceptual motor function Social cognition It is acquired. There is a significant decline from previous functioning. Interferes with independence of daily activities NOT occurring in the course of delirium and are not better accounted for by another mental disorder. Classifications Alzheimer’s Lewy body dementia Frontotemporal dementia Vascular dementia Parkinson’s disease Time course is important to distinguish between them and how decline occurs: Step wise Abrupt Acute Subacute Clinical Presentations History and Physical Examinations History HOPC Assess ADLs Collateral history Through the conversations may be also able to notice a disregard for social norms, memory lapse, comprehension and expression issues. Examination Full physical examinations Rule out a medical cause for presentation Full neurological examination Stroke signs PD signs Gait changes. Assessment in Dementia Treatment and Management Education Non-pharmacological: Behavioural e.g. CBT Environmental -> whiteboards for daily/weekly routines -> oriented. Social -> linking to others -> prevent social isolation. Pharmacological NMDA antagonists Anti-psychotics ACE-I Complications AND EASE Apathy Nursing home placement Enduring guardianship Aggression Social isolation Enduring power of attorney.