Dementia
Definition:
Progressive deterioration of the intellectual and cognitive functions typically with preservation of the level of consciousness.
Epidemiology:
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Over age 65 there is 6% prevalence.
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Over age 85 the prevalence increases to 20%.
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25% of stroke patients will develop dementia.
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Hospital based-study in Saudi Arabia showed a frequency of dementia in general was 19.3/100,000 patients.
Risk factors:
Increasing age: the most important risk factor.
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Family history.
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Gender (female: male ratio is 2:1).
Etiologies:
Study guide:

*NPH: normal pressure hydrocephalus, PML: progressive multifocal leukoencephalopathy, CJD: creutzfeldt jakob disease.
Types:
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Primary neurological disease:
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Alzheimer’s disease
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Vascular dementia
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Space occupying lesions
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NPH
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Dementia with Lewy bodies
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Pick’s disease
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Parkinson’s, Huntington’s disease.
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Infections:
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HIV
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Neurosyphilis
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CJD
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Cryptococcal CNS infection
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PML
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Metabolic diseases:
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Thyroid disorder
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B12, niacin, thiamine deficiency
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Drugs and Toxins:
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Alcohol
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Aniline dyes
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Lead
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Psuedodementia (severe depression)
Diagnosis:
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Laboratory tests:
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CBC with differential
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Chemistry panel
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Thyroid function tests o VLDRL (syphilis)
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VLDRL (syphilis)
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B12 and folate
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HIV screening
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CT or MRI of the head
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Management:
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Treat the reversible causes.
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B12 and folate
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HIV screening
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CT or MRI of the head
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Monitor the patient’s medications: opioids, lithium, hypnotics, anxiolytics, anticholinergic, and glucocorticoids).
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Treat and control the comorbidities: HTN, DM, visual and hearing impairments. o Vitamin E supplements.
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Biopsychosocial approach through multidisciplinary team method.
References:
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Le, Tao, Vikas Bhushan, and Herman Singh Bagga. First Aid For The USMLE Step 2 CK. New York: McGraw-Hill Medical, 2010. Print.
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Yogarajah, Mahinda. Neurology. Edinburgh: Mosby/Elsevier, 2014. Print.
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Agabegi, Steven S, Elizabeth D Agabegi, and Adam C Ring. Step-Up To Medicine. Philadelphia: Wolters
Kluwer/Lippincott Williams & Wilkins, 2013. Print.
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Kumar, Parveen J, and Michael L Clark. Kumar & Clark's Clinical Medicine. Print.
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Hauser, Stephen, and Scott Josephson. Harrison's Neurology In Clinical Medicine. 3rd ed. McGraw Hill. Print.
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Le, Tao, Vikas Bhushan, and Herman Singh Bagga. First Aid For The USMLE Step 2 CK. New York: McGraw-Hill
Medical, 2010. Print.
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N.p., 2015. Print.
First author: Roaa amer
Abdullah AlAsaad
Second author : Lama Al Luhidan
Web Publisher : Adel Yasky
Audio recording:
Read by: Amal Alfarhan
Directed by: Rana Alzahrani
Audio production: Bayan Alzomaili