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Cognitive Impairment / Dementia

 

Dementia is a progressive syndrome: global deterioration in intellectual function, behaviour and personality in the presence of normal consciousness and perception

Many patients have preserved positive personality traits and personal attributes but the following features may become evident as the disease progresses:

  • memory loss, language impairment, disorientation, changes in personality, difficulty in carrying out daily activities, self-neglect
  • psychiatric symptoms - apathy, depression or psychosis
  • unusual behaviour - aggression, sleep disturbance or disinhibited sexual behaviour

History: should be gathered from a person who has known the patient for a period of six months at least and if possible directly from the patient and includes:

  • medical and psychiatric history of the family e.g. – dementia/mental health
  • associations:
    • myoclonus
    • seizures
    • depression, anxiety
  • past and present medical and psychiatric history - e.g. diabetes, HT,CVA
  • exposure to toxins:etoh,lead,or Drugs e.g. barbiturates, illicit drugs

Examination:

  • physical examination –
    • cardiovascular system – for evidence of CVA
    • neurological examination – to detect focal deficits, gait abnormalities, speech abnormalities
  • cognitive examination
    • 30-item Mini Mental State Examination (MMSE)
    • the clock drawing test – to assess praxis and executive function

Investigations:

FBC, Urea+Electrolytes, Glucose, TFTs, LFTs, B12, folate, Lipid Profile, bone

Referral: Memory Clinic / Dementia Clinic with Elderly Care,

    Consider Neurology if under 65, particularly with atypical features

 

Cornwall Carers Service

Anyone can contact the Cornwall Carers Service via the website (http://www.cornwallcarers.org.uk/) or via the Helpline: 01872 266383 (open from 8am to 6pm, Monday to Friday). The Helpline gives information, advice and support to make caring a little easier. Services may include a face to face meeting with one of our Carer Support Workers.

 

Cognitive Impairment/ Dementia contacts

Alzheimer’s Society Helpline including a Telephone Befriending Service: Tel: 01872 277963

Age UK Helpline (providing information on memory cafes and other services and opportunities): 01872 266388

Cornwall Carers Service: Tel: 01872 266383

Cornwall Partnership NHS Foundation Trust’s Memory assessment Clinic: Tel: 01208 251300