The Memory Training Center
Phone: (314) 604-0758
Diagnosis of Dementia:
A. Significant decline in 1 or more cognitive domains, based on:
1. Concerns about significant decline expressed by individuals or reliable informant or observed by clinician.
2. Substantial impairment documented by objective cognitive assessment.
B. Interference with independence in ADL
C. Not exclusively during delirium
D. Not better explained by another mental disorder
E. Specific one or more etiologic subtypes, “due to”
Alzheimer's Disease
CVA (strokes)
Fronto-temporal Dementia (FTD
Lewy Body Dementia (LBD
Parkinson's Disease (PD
Huntington Disease (HD
Traumatic Brain Injury (TBI
Infections (HIV and Prion disease)
Another medical condition
Multiple etiologies
Diagnosis of Mild Cognitive Impairment (MCI)
A. Modest decline in 1 or more cognitive domains, based on:
1. Concerns about mild decline expressed by individuals or reliable informant or observed by clinician.
2. Modest impairment documented by objective cognitive assessment.
B. No Interference with independence in everyday activities, although these activities may require more time and effort, accommodation, or compensatory strategies.
C. Not exclusively during delirium
D. Not better explained by another mental disorder
E. Specific one or more etiologic subtypes, “due to”
Alzheimer's Disease
CVA (strokes)
Fronto-temporal Dementia (FTD
Lewy Body Dementia (LBD
Parkinson's Disease (PD
Huntington Disease (HD
Traumatic Brain Injury (TBI
Infections (HIV and Prion disease)
Another medical condition
Multiple etiologies
Dementia and Cognitive Impairment: Epidemiology, Diagnosis, and Treatment Julie Hugo, MD, Mary Ganguli, MD, MPH. Clin Geriatr Med. 2014 August ; 30(3): 421–442
Types of Dementia
There are several types of dementia
1. Primary dementia: Such as Alzheimer's Disease, Frontotemporal Dementia, Vascular dementia, Lewy Body dementia.
2. Secondary Dementia: Occurs as manifestation to an underlying disease: Parkinson's disease; Huntigton Disease, ALcohol related dementia, Infection related dementia, post traumatic dementia.
3. Reversible Dementia: related to depression, normal pressure hydrocephalus, nutrition and vitamin deficiencies, tumors and bleed inside the brain, and sometimes medications effects.
Early Symptoms of Dementia
1. increased confusion
2. reduced concentration
3. personality changes
4. behavioral changes
5. loss of ability to do every day activities
Cognitive Domains Affected in Dementia
1. Memory
2. Attention/ Working Memory
3. Language
4. Executive Functions (reasoning)
5. Visuospatial
6. Behavior and social
Cognitive Changes noticed in dementia
1. Memory loss
2. Problem communicating words
3. Getting lost at home, outside home in familiar places and or while driving.
4. Trouble problem solving and reasoning.
5. Trouble performing complex tasks
6. Trouble planning and organizing
Risk Factors for Dementia
1. Age
2. Family history
3. Unhealthy diet
4. Lack of exercise and activity
5. Too much alcohol
6. Hypertension (high blood pressure)
7. Hyperlipidemia (high cholesterol)
8. Diabetes
9. Heavy consumption of alcohol.
10. Smoking
11. Depression especially recurrent major depression in earlier adulthood
12. Post Traumatic Stress Disorder (PTSD)
13. Air pollution (traffic exhaust, burning woods)
14. Head trauma especially severe and repeated
15. Sleep problems including obstructive sleep apnea (OSA)
Factors Protective of Dementia
1. Healthy diet-
2. Exercise (physical activities)
3. Social activities and larger social networks
4. Sleep
5. Stop smoking
6. mild-moderate alcohol consumption.
7. Higher education
8. Bilingualism
9. Cognitively stimulating activities
Effects of Dementia
1. Socioeconomic
2. Independence
3. Safety (driving, cooking, and handling finances and medications)
4. Behavioral
++ In the United States, Alzheimer’s disease (AD) is a leading cause of death, hospital admissions, skilled nursing facility admissions, and home health care.
Murphy SL, Xu J, Kochanek KD. Division of Vital Statistics. Deaths: final data for 2010. [Accessed on-line December 19, 2013];National Vital Statistics Reports. 2013 61(4)
++ Family caregivers also experience increased emotional stress, depression, and health problems.
Alzheimer’s Association. 2013 Alzheimer’s disease facts and figures. Alzheimers Dement. 2013;9:208–245
Things to Address with Providers
1. Personality changes
2. Behavioral changes including Hallucinations
3. Depression.
4. Financial decision
5. Safety including Falls, Driving, and medications use.
6. Long term plans