Two of the following cognitive domains are impaired: memory, language, visuospatial or executive function (memory is the most common).Cognitive changes that are of gradual onset over months to years.To diagnose Alzheimer's disease, the patient must display the following features: 4 Impairment not explained by delirium or other major psychiatric disorder.Impairment causes a significant functional decline in usual activities or work and.Impairment in at least 2 of the following cognitive domains: memory, language, visuospatial, executive function and behavior.The diagnosis of dementia requires that the patient display the following features: 4 Presents signs of self-neglect (e.g., hygiene, grooming, unexplained weight loss).ĭiagnostic Criteria of Dementia, Alzheimer's Disease and Mild Cognitive Impairment.Patient is unable to recall treatment instructions or recommendations from prior visits or.Experiences late life depression, or delirium.Defers to family member in answering questions.Confused, forgetful or less compliant about medications.Calls office frequently or inappropriately.The following are examples of cognitive impairment symptoms that may present during office visits and may require further assessment: The caregiver may be a family member, friend or health care worker. € Caregiver refers to the individual(s) primarily responsible for the care of the patient with dementia. Patients may hide symptoms, making it hard to detect cognitive impairment in visits that are time limited or otherwise structured. € Cognitive impairment symptoms tend to be gradual and insidious. This might be reported by the patient, family, friends, health care workers or other caregivers. Suspect cognitive impairment when there is a functional decline in work and usual activities. Screening is recommended with patients with cerebrovascular disease. There is no demonstrable benefit to screening asymptomatic patients. 3 Dementia prevalence is positively correlated with age. It is estimated that between 60,000 and 70,000 British Columbians have dementia, 60% of whom are female. While Alzheimer's disease is the most common dementia, mixed dementias are becoming increasingly recognized (see Figure 1: Sub-types of dementia commonly seen in Canadian memory clinics). 1 Dementia refers to Alzheimer's disease (AD) and other dementia sub-types including vascular dementia (VaD), mixed forms of dementia and less common forms of dementia such as dementia with Lewy bodies (DLB), frontotemporal dementia and Parkinson's disease dementia (PDD).Īlzheimer's disease and other neurodegenerative dementia sub-types are progressive, irreversible brain diseases that lead to a decline in memory and other cognitive functions sufficient to impact activities of daily living. Mild cognitive impairment refers to a cognitive decline that does not significantly impair cognitive function. Make early and regular use of adjunct services.Ĭognitive impairment refers to mild cognitive impairment and dementia.Drug treatment has limited value first consider non-pharmacological management of the behavioural and psychological symptoms of dementia.Polypharmacy and multimorbidity can both be causes and effects of cognitive impairment.Always involve the caregiver and plan on several visits to establish and inform patient/caregiver of diagnosis.Dementia can be masked in a typically structured office visit third party observations can be important.Do not screen asymptomatic population for cognitive impairment.The guideline encourages early recognition and assessment of dementia and supports the development of a care plan that includes the identification of community resources for patients and caregivers. The guideline focuses on Alzheimer's disease, the most common form of dementia seen in primary care. This guideline provides recommendations for the recognition, diagnosis and management of cognitive impairment in adults ≥ 19 years within the primary care setting. Revised Date: JRecommendations and Topics
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