Diagnosing Dementia: Signs & symptoms, differential diagnosis of common dementias, and non-degenerative memory loss

Size: px
Start display at page:

Download "Diagnosing Dementia: Signs & symptoms, differential diagnosis of common dementias, and non-degenerative memory loss"

Transcription

1 Diagnosing Dementia: Signs & symptoms, differential diagnosis of common dementias, and non-degenerative memory loss

2 Incidence of Common Neurological Diseases Incidence New Cases Disease (per 100,000) (per year) Dementia ,000 Alzheimer s disease ,000 Stroke ,000 Seizures ,000 Parkinson s disease 16 40,000 Primary neoplasm 15 37,500 Amyotrophic lateral sclerosis 6 15,000 Primary brain tumor 6 15,000 Multiple sclerosis 2 5,000 Gullain Barre 1 2,500 Huntington s disease

3 Diagnostic Classifications

4

5 Mild Cognitive Impairment Cognitive Mild Cognitive Impairment MCI (memory) 10% - 15% conversion to AD per year 50% Conversion after 5 yrs >90% conversion by 10 years Criteria Memory difficulties corroborated by informant that interfere with adaptive functioning Selective deficit as measured by neuropsychological tests; other functions normal or near normal Intact IADLs Not demented Petersen 98 Neurology; Fisk 03 Neurology, Morris 01, Neurology

6 Diagnostic Criteria of MCI Clinical and cognitive criteria Cognitive concern reflecting a change in cognition reported by patient or informant or clinician (historical or observed evidence of decline) Objective evidence of impairment in one or more cognitive domains, typically including memory (formal or bedside testing) Preservation of independence in functional abilities Not demented Examine etiology of MCI consistent with AD pathophysiology Rule out vascular, traumatic, medical causes of cognitive decline Provide evidence of longitudinal decline in cognition Report history consistent with AD genetic factors Albert et al, Alzheimer s and Dementia 2011

7 Clinical Criteria for MCI of AD Type Subjective memory complaint reported by subject or informant Global cognition intact (MMSE >25) Memory impairment confirmed objectively ADL impairment is insufficient for diagnosis of dementia; IADL may be effected (GDS = 3 or CDR = 0.5) No medical / other etiology for memory deficit.

8 MCI: Definitions and Categories MCI Amnestic Forms Non Amnestic Forms Single Domain Multiple Domains Single Domain Multiple Domains

9 Albert 2011, Alzforum.org

10 Diagnosis of MCI Not established by consensus criteria Clinically apply Petersen criteria Neuropsychological assessment Apo E genotyping Screening eval (imaging, standard labs) low yield

11 Prediction of Conversion from MCI to AD MCI conversions to AD can be predicted by Worse memory scores Smaller hippocampi Low CSF Ab and high tau (ADNI reports that 33/37 subject converting to AD within one year had the CSF profile) ApoE4 positivity PIB uptake

12 Follow-Up of PIB-Positive ADNI MCI s N = 65, 12 mo. follow-up PiB(+)= 47 Converters to AD=14 PiB(-)=18 Converters to AD=3

13 PiB-Positivity in Predicting Clinical Conversion in MCI Melbourne Cohort N=28, 21 mo. follow-up PiB(-)=13 Converters to AD=1 PiB(+)=15 Converters to AD=12 Pittsburgh Cohort N=23, 24 mo. follow-up PiB(-)=10 Converters to AD =0 PiB(+)=13 Converters to AD =5

14

15

16 Diagnostic Criteria of Dementia A. Dementia Interferes with ability to function at work or at usual activities A decline from a previous level of functioning Not delirium or psychiatric disorder Diagnosed by history, examination Involves at least 2 cognitive domains: Memory Reasoning and judgment Visuospatial Language Personality, behavior, comportment McKhann et al, Alzheimer s and Dementia 2011

17 Diagnostic Criteria of AD A. Probable AD [based on clinical criteria] Dementia Insidious onset Worsening of cognition over time Amnestic vs. non-amnestic presentation Not due to another dementia diagnosis B. Probable AD with evidence of AD pathophysiology Ab (CSF or amyloid PET) Neuronal injury (CSF tau, FDG-PET, structural MRI) McKhann et al, Alzheimer s and Dementia 2011

18

19 2018 ATN Criteria

20

21 Differential Diagnosis of Dementia Alzheimer s Disease (AD) Dementia with Lewy Bodies (DLB) AD & Vascular Dementia (mixed) Vascular Dementia Frontotemporal Dementia (FTD) Parkinson s Disease Huntington s Disease Other Degenerative Diseases (PSP, OPCA, ALS with dementia) Dementias Secondary to Alcohol Depression/Pseudodementia Normal Pressure Hydrocephalus (NPH) Structural Lesions Metabolic Disorders (Hypothyroidism) Infections (e.g. neurosyphillis, AIDS, CJD) Drug Intoxication

22 Dementia with Lewy Bodies Parkinsonism coexisting with cognitive decline Visual hallucinations Clinical fluctuations Neuroleptic sensitivity Newest criteria: REM behavioral disturbance Cognitive pattern may be subcortical or mixed cortical/subcortical with prominent visuospatial abnormalities Prone to other neuropsychiatric features May possibly progress faster Pathologically characterized by worse cholinergic loss, fewer plaques and tangles, neocortical Lewy bodies, lower Braak stages. Treatment could include cholinesterase inhibitors and L-dopa

23 Vascular Dementia May start abruptly immediately after a cerebrovascular accident Multi-focal distribution of cognitive decline Focal neurologic exam Gait disturbance, incontinence, and fluctuating changes are common (aka Binswanger s [290.12] Vascular changes on imaging obligatory NINDS-AIREN criteria applicable Most vascular dementia mixed with AD Hachinski Score 7 Treatment involves management of stroke risk factors and ChEIs

24 Frontotemporal Dementias Also known as Pick s disease Now many linked to Chromosome 17 ( the tau-opathies ) Usually earlier age of onset compared to AD (average years old) Early prominent language changes including anomia, aphasia, echolalia, and perseverative speech Social skills lost early Inappropriate behavior and judgement, disinhibition, and lack of insight Personality changes and withdrawal prominent

25 Progressive Aphasias Early prominent language changes including anomia, aphasia, echolalia, and perseverative speech Three subtypes now recognized (logopenic progressive aphasia-frontal variant, semantic dementia, progressive non fluent aphasia Progressive non fluent aphasia Involves effortful speech with agrammatism and frequent apraxia of speech Post-hoc comparisons with HC showed bilateral GM atrophy in the caudate, putamen and thalamus, in bvftd; a left-confined GM reduction in the amygdala in SD; and bilateral GM atrophy in the caudate and thalamus, and left-sided GM reduction in the putamen and amygdala in PNFA. Left insula and adjacent inferior frontal gyrus Pathologically associated with CBD or FTLD pathology with tau inclusions or PSP Semantic dementia Characterized by loss of word and object meaning and understanding Abnormalities in the left rostral temporal lobes Ubiquitin positive TDP proteinopathy pathology have both been associated with it Logopenic Progressive Aphasia speech rate was slow, with long word-finding pauses. Grammar and articulation were preserved, although phonological paraphasias could be present. Moderate anomia Repetition and comprehension were impaired for sentences but preserved for single words, and naming was moderately affected. Atrophy or decreased blood flow was consistently found in the posterior portion of the left superior and middle and posterior temporal gyri and inferior parietal lobule. Recent studies suggest that Alzheimer disease may be the most common pathology underlying the LPA clinical syndrome.

26 Degenerative Dementias AD DLB FTD Mixed Dementias Prion Diseases Parkinson s Disease Huntington s Disease Progressive Supranuclear Palsy Guamanian ALS-PD-AD

27 Dementias Possibly Amenable to Treatment Hypothyroidism Neurosyphillis/ Infectious Etiologies Normal Pressure Hydrocephalus Vascular Dementia Vitamin B12 Deficiency Structural Lesions Metabolic Disorders Drug Intoxication Depression/Pseudodementia Wilson s Disease Alcohol Related Dementias

28 Dementias Associated with Other Neurological Signs and Symptoms AIDS (neuropathy, myopathy) Normal Pressure Hydrocephalus (gait disturbance, incontinence) Tumors/Mass Lesions (stroke-like symptoms that are subacute and evolving) Subdural Hematoma (stroke-like symptoms that are acute or subacute and evolving)

29 Normal Pressuer Hydrocephalus

30

31

32 Dementias Associated with Other Neurological Signs and Symptoms Huntington s Disease (chorea, depression, psychosis, parkinsonism) Creutzfeldt Jakob Disease (myoclonus, rapid dementia, EEG changes) Parkinson s Disease (rigidity, bradykinesia, gait disturbance, tremor) B12 Deficiency (Often associated with subacute combined degeneration: proprioceptive loss, parethesias, hyperreflexia)

33 Ten Warning Signs of AD Memory loss that affects job skills Difficulty performing familiar tasks Problems with language Disorientation to time and place Poor or decreased judgement Problems with abstract thinking Misplacing things Changes in mood or behavior Changes in personality Loss of initiative

34 Risk Factors for cognitive decline

35 Risk Factors for Cognitive Decline age genetic influences ApoE status female gender medical comorbidities

36 Risk Factors for Cognitive Decline: Medical Comorbidities Hypertension Heart disease Diabetes Elevated low-density lipoprotein cholesterol High homocysteine levels Transitory ischemic attacks (TIAs) Head trauma Environmental exposure to toxins (particularly lead)

37 Approach to diagnosis

38 Why is an accurate diagnosis important in AD? Accurate diagnosis reduces uncertainty and anxiety Accurate diagnosis allows increased confidence in distinguishing AD from other dementias Accurate diagnosis allows realistic prognostication Accurate diagnosis allows increase treatment precision Accurate diagnosis allows open discussion of expectations

39 Evaluation of Patients with Dementia Routine History Mental Status Exam Neurological Exam Chemistry Panel Complete Blood Count Vitamin B12 level Thyroid function studies CT/MRI Optional Syphilis serology Sedimentation Rate Chest X-Ray Electrocardiogram Urinalysis Drug Levels HIV testing Lyme Serology EEG PET/SPECT Apo E genotyping CSF (Ab42/tau or for CJD)

40 Case Vignette 72 y.o. female with 16 years of education presents with 2 years of progressive cognitive decline manifested by repeating questions and statements. She has disorientation to time and date, functional decline manifested by inability to complete household tasks and word finding difficulty. Neuro Exam is normal and MMSE is 25/30. Before ordering any tests, what is the diagnosis and how accurate are you?

41 Probable or Possible AD 70%

42

43

44 New Concept: Diagnosis of AD RPR no longer required; now considered optional; appropriate if risk factors are present Structural imaging is now considered a standard Apo E genotyping is an option CSF studies is an option for detection of AD and CJD Functional imaging approved with caveats

45

46 The Apolipoprotein E Genotype Advantages Highly predictive of AD; an E4 carrier that is symptomatic has a 94-97% of having AD pathology 50% of MCI subjects that are E4 homozygotes convert to AD in 3 years versus 20% of non-e4 carriers MCI subjects (amnestic subtype) that are E4 carriers convert to AD >99% of the time when they convert It is a simple blood test Can assist in assessing risk of offspring May predict effect of medication Disadvantages May or may not be covered by Medicare or secondary insurance $>350 cost non E4 carrier does not equal no AD. Apo E estimates risk and is not a sine qua non for AD.

47

48

49 What about CSF testing for AD? CSF testing is desirable because it directly measures changes occurring in the CNS CSF testing can measure Ab, tau, p-tau AD subjects have reduced Ab42, increased tau and increased p-tau CSF testing for NTP has not been accurate or reliable and may reflect leakage from blood (FDA denied approval)

50

51 CSF Testing for AD Advantages Allows precise measurement of AD specific changes Ab42 combined with tau has a sensitivity of 89% and a specificity of 90.2% compared to controls p-tau increases specificity to 85% from other dementias and 92% from controls New data from ADNI suggest that CSF predicts conversion from MCI to AD before symptoms fully manifes Disadvantages Requires LP Usually not covered by Medicare >$1000

52 Proportion free of very mild AD Proportion free of AD Abnormal CSF Tau/Aβ 42 and Prediction of Clinical Decline CSF amyloidβ level (pg/ml) Normal Consistent with AD pathology From normal to very mild AD CSF tau level (pg/ml) From MCI to AD 27% vs 1% annual conversion rate CSF tau/ab 42 < Time (years) Normal Pathological CSF CSF Time (months) Shaw LM et al. Ann Neurol. 2009;65: Fagan AM et al. Arch Neurol. 2007;64: Li G et al. Neurology. 2007;69: Hansson O et al. Lancet Neurol. 2006;5:

53 Structural Neuroimaging for AD Diagnosis Advantages MRI and CT have high sensitivity in detecting structural abnormalities and large pathological events (e.g. tumors, hydrocephalus, stroke) Cost is $ and is covered by insurance Disadvantages Clinical MRI and CT have low sensitivity to detect AD Clinical MRI and CT have very low specificity to distinguish one type of dementia from another New structural imaging technology requires serial imaging for accuracy

54 MRI: Hippocampal Atrophy in AD Normal AD

55 PET Scan for AD Advantages Sensitivity >90% even at fairly early stage Positive predictive value >90% Relatively non-invasive Disadvantages Costs between $ Significant radiation exposure Interpretation highly variable according to radiologist training Specificity 75% Requires Medicare prior authorization which is complicated and time consuming

56 FDG-PET in Normal Aging, MCI, AD, and FTD NL MCI pad ftd NL = normal; pad = probable Alzheimer s disease; ftd = frontotemporal dementia. Reiman EM et al. N Engl J Med. 1996;334: Reiman EM et al. Proc Natl Acad Sci U S A. 2001;98: Reiman EM et al. Proc Natl Acad Sci U S A. 2004;101: Reiman EM et al. Proc Natl Acad Sci U S A. 2005;102:

57 F18 Amyloid Imaging Tracers Flutemetamol 1 Florbetapir 2 AD Interpreting amyloid PET scans Negative Positive NL A A Florbetaben 3 Navidea NAV C D C D AD B B NL 1. Vandenberghe R et al. Ann Neurol. 2010;68: Wong DF et al. J Nucl Med. 2010;51: Barthel H et al. Lancet Neurol. 2011;10: Chen K et al. Alzheimers Dement. 2012;8(4 suppl):p14(abstract IC-P-011).

58 Specific binding (fmol/mg) Bound/Fr ee Amyloid imaging with florbetapir F 18 5,00 0 4,00 0 3,00 0 2,00 0 1, Kd = 3.51 nm Bmax = 7,215 fmol/mg) ,0002,0003,0004,0005,0006,0007,000 Florbetapir (pm) Florbetapir F 18 2,50 5,000 7,500 0Bound Clark CM 1,2, Schneider JA 3, Bedell BJ 4,5, Beach TG 6, Mintun MA 1,7, Pontecorvo MJ 1, Hefti F 1, Carpenter A 1, Flitter M 1, Krautkramer M 1, Kung HF 2, Coleman RE 8, Fleischer A 9,10, Sabbagh M, Sadowsky C, Doraiswamy PM 8, Reiman EM 9, Skovronsky DM 1, and the AV45-A07 study group. Validation of Florbetapir-PET for Imaging Alzheimer s Disease Amyloid Pathology. JAMA 2011; 305(3): A. B. C. D. E. F.

59 Amyloid positivity (%) Amyloid Positivity, by Cognition and Age Prevalence estimates of amyloid positivity according to cognitive status and age Normal cognition (n = 2914) SCI (n = 697) MCI (n = 3971) Age (years) SCI = subjective cognitive impairment The prevalence estimates were generated from generalized estimating equations. Shading indicates 95% CI. Jansen WJ et al. JAMA. 2015;313:

60 Conclusions The identification of MCI can be made with more confidence The prediction of conversion from MCI to AD can be made with greater accuracy AD is no longer a diagnosis of exclusion Technology is becoming available that greatly improves the diagnostic accuracy of AD

Form D1: Clinician Diagnosis

Form D1: Clinician Diagnosis Initial Visit Packet Form D: Clinician Diagnosis NACC Uniform Data Set (UDS) ADC name: Subject ID: Form date: / / Visit #: Examiner s initials: INSTRUCTIONS: This form is to be completed by the clinician.

More information

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Dementia Update October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Outline New concepts in Alzheimer disease Biomarkers and in vivo diagnosis Future trends

More information

Clinical Diagnosis. Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV)

Clinical Diagnosis. Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV) Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV) A. The development of multiple cognitive deficits manifested by both 1 and 2 1 1. Memory impairment 2. One (or more) of the following

More information

DISCLOSURES. Objectives. THE EPIDEMIC of 21 st Century. Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia NONE TO REPORT

DISCLOSURES. Objectives. THE EPIDEMIC of 21 st Century. Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia NONE TO REPORT Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia DISCLOSURES NONE TO REPORT Freddi Segal Gidan, PA, PhD USC Keck School of Medicine Rancho/USC California Alzheimers Disease

More information

FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS

FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS Norman L. Foster, M.D. Director, Center for Alzheimer s Care, Imaging and Research Chief, Division of Cognitive Neurology, Department of Neurology

More information

DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD

DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD OBJECTIVES Terminology/Dementia Basics Most Common Types Defining features Neuro-anatomical/pathological underpinnings Neuro-cognitive

More information

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient DEMENTIA WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient Progressive and disabling Not an inherent aspect of

More information

Dementia Past, Present and Future

Dementia Past, Present and Future Dementia Past, Present and Future Morris Freedman MD, FRCPC Division of Neurology Baycrest and University of Toronto Rotman Research Institute, Baycrest CNSF 2015 Objectives By the end of this presentation,

More information

Assessing and Managing the Patient with Cognitive Decline

Assessing and Managing the Patient with Cognitive Decline Assessing and Managing the Patient with Cognitive Decline Center of Excellence For Alzheimer s Disease for State of NY Capital Region Alzheimer s Center of Albany Medical Center Earl A. Zimmerman, MD Professor

More information

Mild Cognitive Impairment (MCI)

Mild Cognitive Impairment (MCI) October 19, 2018 Mild Cognitive Impairment (MCI) Yonas E. Geda, MD, MSc Professor of Neurology and Psychiatry Consultant, Departments of Psychiatry & Psychology, and Neurology Mayo Clinic College of Medicine

More information

Delirium & Dementia. Nicholas J. Silvestri, MD

Delirium & Dementia. Nicholas J. Silvestri, MD Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural pathways relating to consciousness Encephalopathy Stupor Coma Dementia Delirium vs. Dementia Delirium Abrupt onset Lasts

More information

I do not have any disclosures

I do not have any disclosures Alzheimer s Disease: Update on Research, Treatment & Care Clinicopathological Classifications of FTD and Related Disorders Keith A. Josephs, MST, MD, MS Associate Professor & Consultant of Neurology Mayo

More information

A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies

A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies Lynda Mackin, PhD, AGPCNP-BC, CNS University of California San Francisco School of Nursing 1 Alzheimer s

More information

What if it s not Alzheimer s? Update on Lewy body dementia and frontotemporal dementia

What if it s not Alzheimer s? Update on Lewy body dementia and frontotemporal dementia What if it s not Alzheimer s? Update on Lewy body dementia and frontotemporal dementia Dementia: broad term for any acquired brain condition impairing mental function such that ADLs are impaired. Includes:

More information

Dementia Update. Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota

Dementia Update. Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Dementia Update Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Nothing to disclose Dementia Progressive deterioration in mental function

More information

Form A3: Subject Family History

Form A3: Subject Family History Initial Visit Packet NACC Uniform Data Set (UDS) Form A: Subject Family History ADC name: Subject ID: Form date: / / Visit #: Examiner s initials: INSTRUCTIONS: This form is to be completed by a clinician

More information

Dementia: A Comprehensive Update Neuroimaging, CSF, and genetic biomarkers in dementia

Dementia: A Comprehensive Update Neuroimaging, CSF, and genetic biomarkers in dementia Dementia: A Comprehensive Update 2016 Neuroimaging, CSF, and genetic biomarkers in dementia Bradford C. Dickerson, M.D. Associate Professor of Neurology, Harvard Medical School Departments of Neurology

More information

Non Alzheimer Dementias

Non Alzheimer Dementias Non Alzheimer Dementias Randolph B Schiffer Department of Neuropsychiatry and Behavioral Science Texas Tech University Health Sciences Center 9/11/2007 Statement of Financial Disclosure Randolph B Schiffer,,

More information

The frontotemporal dementia spectrum what the general physician needs to know Dr Jonathan Rohrer

The frontotemporal dementia spectrum what the general physician needs to know Dr Jonathan Rohrer The frontotemporal dementia spectrum what the general physician needs to know Dr Jonathan Rohrer MRC Clinician Scientist Honorary Consultant Neurologist Dementia Research Centre, UCL Institute of Neurology

More information

Part 2: Early detection, assessment and treatment in relation to the new guidelines. Christopher Patterson McMaster University

Part 2: Early detection, assessment and treatment in relation to the new guidelines. Christopher Patterson McMaster University Part 2: Early detection, assessment and treatment in relation to the new guidelines Christopher Patterson McMaster University C. Patterson MD, FRCPC Division of Geriatric Medicine, McMaster University

More information

Prof Tim Anderson. Neurologist University of Otago Christchurch

Prof Tim Anderson. Neurologist University of Otago Christchurch Prof Tim Anderson Neurologist University of Otago Christchurch Tim Anderson Christchurch Insidious cognitive loss From subjective memory complaints (SMC) to dementia Case 1. AR. 64 yrs Male GP referral

More information

Dementia. Assessing Brain Damage. Mental Status Examination

Dementia. Assessing Brain Damage. Mental Status Examination Dementia Assessing Brain Damage Mental status examination Information about current behavior and thought including orientation to reality, memory, and ability to follow instructions Neuropsychological

More information

Diagnosis and Treatment of Alzhiemer s Disease

Diagnosis and Treatment of Alzhiemer s Disease Diagnosis and Treatment of Alzhiemer s Disease Roy Yaari, MD, MAS Director, Memory Disorders Clinic, Banner Alzheimer s Institute 602-839-6900 Outline Introduction Alzheimer s disease (AD)Guidelines -revised

More information

Dementia. Dr Maria Foundas Consultant Physician. Training support Skills development Competency Assessment Scholarships Education

Dementia. Dr Maria Foundas Consultant Physician. Training support Skills development Competency Assessment Scholarships Education Dementia Dr Maria Foundas Consultant Physician Training support Skills development Competency Assessment Scholarships Education Preamble and disclaimer These slides are made available by the Western Australian

More information

Diagnosis and management of non-alzheimer dementias. Melissa Yu, M.D. Department of Neurology

Diagnosis and management of non-alzheimer dementias. Melissa Yu, M.D. Department of Neurology Diagnosis and management of non-alzheimer dementias Melissa Yu, M.D. Department of Neurology AGENDA Introduction When to think of alternate diagnoses Other forms of dementia Other reasons for confusion

More information

Differentiating Dementia Diagnoses

Differentiating Dementia Diagnoses Differentiating Dementia Diagnoses Waitemata PHO 21 October 2014 Dr Michal Boyd, RN, NP, ND Nurse Practitioner Older Adults School of Nursing & Freemasons Dept. of Geriatric Medicine The University of

More information

DEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease

DEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease What is PRESENTS DEMENTIA? WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: Memory Reasoning Planning Learning Attention Language Perception Behavior AS OF 2013 There

More information

Dementia. Stephen S. Flitman, MD Medical Director 21st Century Neurology

Dementia. Stephen S. Flitman, MD Medical Director 21st Century Neurology Dementia Stephen S. Flitman, MD Medical Director 21st Century Neurology www.neurozone.org Dementia is a syndrome Progressive memory loss, plus Progressive loss of one or more cognitive functions: Language

More information

Neuro degenerative PET image from FDG, amyloid to Tau

Neuro degenerative PET image from FDG, amyloid to Tau Neuro degenerative PET image from FDG, amyloid to Tau Kun Ju Lin ( ) MD, Ph.D Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital ( ) Department of Medical Imaging

More information

Dementia. Amber Eker, MD. Assistant Professor Near East University Department of Neurology

Dementia. Amber Eker, MD. Assistant Professor Near East University Department of Neurology Dementia Amber Eker, MD Assistant Professor Near East University Department of Neurology Dementia An acquired syndrome consisting of a decline in memory and other cognitive functions Impairment in social

More information

Dementia and Delirium: A Neurologist s Approach to Altered Mental Status. Case 1 4/7/11. Which of the following evaluations is your next step?

Dementia and Delirium: A Neurologist s Approach to Altered Mental Status. Case 1 4/7/11. Which of the following evaluations is your next step? Dementia and Delirium: A Neurologist s Approach to Altered Mental Status S. Andrew Josephson, MD Director, Neurohospitalist Program Medical Director, Inpatient Neurology University of California San Francisco

More information

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018 Improving diagnosis of Alzheimer s disease and lewy body dementia Brain TLC October 2018 Plan for this discussion: Introduction to AD and LBD Why do we need to improve diagnosis? What progress has been

More information

Diagnosis before NIA AA The impact of FDG PET in. Diagnosis after NIA AA Neuropathology and PET image 2015/10/16

Diagnosis before NIA AA The impact of FDG PET in. Diagnosis after NIA AA Neuropathology and PET image 2015/10/16 The impact of FDG PET in degenerative dementia diagnosis Jung Lung, Hsu MD, Ph.D (Utrecht) Section of dementia and cognitive impairment Department of Neurology Chang Gung Memorial Hospital, Linkou, Taipei

More information

FTD basics! Etienne de Villers-Sidani, MD!

FTD basics! Etienne de Villers-Sidani, MD! FTD basics! Etienne de Villers-Sidani, MD! Frontotemporal lobar degeneration (FTLD) comprises 3 clinical syndromes! Frontotemporal dementia (behavioral variant FTD)! Semantic dementia (temporal variant

More information

Objectives. Objectives continued: 3/24/2012. Copyright Do not distribute or replicate without permission 1

Objectives. Objectives continued: 3/24/2012. Copyright Do not distribute or replicate without permission 1 Frontotemporal Degeneration and Primary Progressive Aphasia Caregiver and Professional Education Conference Diana R. Kerwin, MD Assistant Professor of Medicine-Geriatrics Cognitive Neurology and Alzheimer

More information

Perspectives on Frontotemporal Dementia and Primary Progressive Aphasia

Perspectives on Frontotemporal Dementia and Primary Progressive Aphasia Perspectives on Frontotemporal Dementia and Primary Progressive Aphasia Bradley F. Boeve, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Alzheimer s Disease

More information

Introduction to Dementia: Diagnosis & Evaluation. Created in March 2005 Duration: about 15 minutes

Introduction to Dementia: Diagnosis & Evaluation. Created in March 2005 Duration: about 15 minutes Introduction to Dementia: Diagnosis & Evaluation Created in March 2005 Duration: about 15 minutes Axel Juan, MD The Geriatrics Institute axel.juan@med.va.gov 305-575-3388 Credits Principal medical contributor:

More information

Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic Guidelines? The Debate Continues

Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic Guidelines? The Debate Continues Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic s? The Debate Continues Ever since new criteria came out for a research diagnosis of prodromal/preclinical

More information

Dementia. Aetiology, pathophysiology and the role of neuropsychological testing. Dr Sheng Ling Low Geriatrician

Dementia. Aetiology, pathophysiology and the role of neuropsychological testing. Dr Sheng Ling Low Geriatrician Dementia Aetiology, pathophysiology and the role of neuropsychological testing Dr Sheng Ling Low Geriatrician Topics to cover Why is dementia important What is dementia Differentiate between dementia,

More information

UDS version 3 Summary of major changes to UDS form packets

UDS version 3 Summary of major changes to UDS form packets UDS version 3 Summary of major changes to UDS form packets from version 2 to VERSION 3 february 18 final Form A1: Subject demographics Updated question on principal referral source to add additional options

More information

The ABCs of Dementia Diagnosis

The ABCs of Dementia Diagnosis The ABCs of Dementia Diagnosis Dr. Robin Heinrichs, Ph.D., ABPP Board Certified Clinical Neuropsychologist Associate Professor, Psychiatry & Behavioral Sciences Director of Neuropsychology Training What

More information

Yin-Hui Siow MD, FRCPC Director of Nuclear Medicine Southlake Regional Health Centre

Yin-Hui Siow MD, FRCPC Director of Nuclear Medicine Southlake Regional Health Centre Yin-Hui Siow MD, FRCPC Director of Nuclear Medicine Southlake Regional Health Centre Today Introduction to CT Introduction to MRI Introduction to nuclear medicine Imaging the dementias The Brain ~ 1.5

More information

What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias

What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias Presenter: Kim Bailey, MS Gerontology, Program & Education Specialist, Alzheimer s Orange County 1 1 Facts About Our

More information

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries Clinical Differences Among Four Common Dementia Syndromes a program of Morningside Ministries Introduction Four clinical dementia syndromes account for 90% of all cases after excluding reversible causes

More information

Introduction, use of imaging and current guidelines. John O Brien Professor of Old Age Psychiatry University of Cambridge

Introduction, use of imaging and current guidelines. John O Brien Professor of Old Age Psychiatry University of Cambridge Introduction, use of imaging and current guidelines John O Brien Professor of Old Age Psychiatry University of Cambridge Why do we undertake brain imaging in AD and other dementias? Exclude other causes

More information

Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana

Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana FINANCIAL DISCLOSURE No potential conflict of interest to disclose. OBJECTIVES

More information

Frontotemporal Dementia: Towards better diagnosis. Frontotemporal Dementia. John Hodges, NeuRA & University of New South Wales, Sydney.

Frontotemporal Dementia: Towards better diagnosis. Frontotemporal Dementia. John Hodges, NeuRA & University of New South Wales, Sydney. I.1 I.2 II.1 II.2 II.3 II.4 II.5 II.6 III.1 III.2 III.3 III.4 III.5 III.6 III.7 III.8 III.9 III.10 III.11 III.12 IV.1 IV.2 IV.3 IV.4 IV.5 Frontotemporal Dementia: Towards better diagnosis Frontotemporal

More information

The Person: Dementia Basics

The Person: Dementia Basics The Person: Dementia Basics Objectives 1. Discuss how expected age related changes in the brain might affect an individual's cognition and functioning 2. Discuss how changes in the brain due to Alzheimer

More information

Is PET/CT really helpful in diagnosing Alzheimer s Disease?

Is PET/CT really helpful in diagnosing Alzheimer s Disease? Is PET/CT really helpful in diagnosing Alzheimer s Disease? J. Rudolf MD Ph.D. Consultant in Neurology, Dept. of Neurology, General Hospital Papageorgiou Thessaloniki, Greece Conflict of Interest PET/CT

More information

Alzheimer s disease dementia: a neuropsychological approach

Alzheimer s disease dementia: a neuropsychological approach Alzheimer s disease dementia: a neuropsychological approach Dr. Roberta Biundo, PhD Neuropsychology Coordinator at Parkinson s disease and movement disorders unit of San Camillo rehabilitation hospital

More information

2016 Programs & Information

2016 Programs & Information Mayo Alzheimer s Disease Research Clinic Education Center 2016 Programs & Information BROCHURE TITLE FLUSH RIGHT for Persons & Families impacted by Mild Cognitive Impairment Alzheimer s Disease Dementia

More information

Regulatory Challenges across Dementia Subtypes European View

Regulatory Challenges across Dementia Subtypes European View Regulatory Challenges across Dementia Subtypes European View Population definition including Early disease at risk Endpoints in POC studies Endpoints in pivotal trials 1 Disclaimer No CoI The opinions

More information

Overview. Overview. Parkinson s disease. Secondary Parkinsonism. Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits

Overview. Overview. Parkinson s disease. Secondary Parkinsonism. Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits Overview Overview Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits The differential diagnosis of Parkinson s disease Primary vs. Secondary Parkinsonism Proteinopathies:

More information

Dementia: It s Not Always Alzheimer s

Dementia: It s Not Always Alzheimer s Dementia: It s Not Always Alzheimer s A Caregiver s Perspective Diane E. Vance, Ph.D. Mid-America Institute on Aging and Wellness 2017 My Background Caregiver for my husband who had Lewy Body Dementia

More information

DEMENTIA ANDREA BERG, MD

DEMENTIA ANDREA BERG, MD DEMENTIA ANDREA BERG, MD What Is Dementia? Decline in memory, language, problem-solving and other cognitive skills that affects a persons ability to perform everyday activities Progressive and disabling

More information

Imaging in Dementia:

Imaging in Dementia: Imaging in Dementia: Options for Clinical Practice 2017 John A. Bertelson, MD Clinical Chief of Neurology, Seton Brain and Spine Institute Assistant Professor of Medicine, Dell Medical School, UT Austin

More information

The Aging Brain The Aging Brain

The Aging Brain The Aging Brain The Aging Brain The Aging Brain R. Scott Turner, MD, PhD Director, Memory Disorders Program Professor, Department of Neurology Georgetown University Washington, DC memory.georgetown.edu rst36@georgetown.edu

More information

Moving Targets: An Update on Diagnosing Dementia in the Clinic

Moving Targets: An Update on Diagnosing Dementia in the Clinic Moving Targets: An Update on Diagnosing Dementia in the Clinic Eric McDade DO Department of Neurology School of Medicine Alzheimer Disease Research Center Disclosures No relevant financial disclosures

More information

MOVEMENT DISORDERS AND DEMENTIA

MOVEMENT DISORDERS AND DEMENTIA MOVEMENT DISORDERS AND DEMENTIA FOCUS ON DEMENTIA WITH LEWY BODIES MADHAVI THOMAS MD NORTH TEXAS MOVEMENT DISORDERS INSTITUTE, INC DEMENTIA de men tia dəˈmen(t)sh(ē)ə/ nounmedicine noun: dementia a chronic

More information

review of existing studies on ASL in dementia Marion Smits, MD PhD

review of existing studies on ASL in dementia Marion Smits, MD PhD review of existing studies on ASL in dementia Marion Smits, MD PhD Associate Professor of Neuroradiology Department of Radiology, Erasmus MC, Rotterdam (NL) Alzheimer Centre South-West Netherlands, Rotterdam

More information

Dr Roger Cable NHS Dumfries and Galloway

Dr Roger Cable NHS Dumfries and Galloway Dr Roger Cable NHS Dumfries and Galloway Young Onset Dementia Statistics What is dementia Diagnosing dementia History Examination Tests Subtypes of dementia 315000 Cost of dementia (Alzheimer s society)

More information

NIH Public Access Author Manuscript Semin Neurol. Author manuscript; available in PMC 2014 November 14.

NIH Public Access Author Manuscript Semin Neurol. Author manuscript; available in PMC 2014 November 14. NIH Public Access Author Manuscript Published in final edited form as: Semin Neurol. 2013 September ; 33(4): 386 416. doi:10.1055/s-0033-1359312. Neuroimaging Biomarkers of Neurodegenerative Diseases and

More information

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey ALZHEIMER S DISEASE Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey Topics Covered Demography Clinical manifestations Pathophysiology Diagnosis Treatment Future trends Prevalence and Impact

More information

Brain imaging for the diagnosis of people with suspected dementia

Brain imaging for the diagnosis of people with suspected dementia Why do we undertake brain imaging in dementia? Brain imaging for the diagnosis of people with suspected dementia Not just because guidelines tell us to! Exclude other causes for dementia Help confirm diagnosis

More information

Assessment at the bedside or in the clinic using the history, examination and laboratory tests to distinguish between different types of dementia

Assessment at the bedside or in the clinic using the history, examination and laboratory tests to distinguish between different types of dementia Assessment at the bedside or in the clinic using the history, examination and laboratory tests to distinguish between different types of dementia AP Passmore Content Common dementia syndromes (older people)

More information

DSM-5 MAJOR AND MILD NEUROCOGNITIVE DISORDERS (PAGE 602)

DSM-5 MAJOR AND MILD NEUROCOGNITIVE DISORDERS (PAGE 602) SUPPLEMENT 2 RELEVANT EXTRACTS FROM DSM-5 The following summarizes the neurocognitive disorders in DSM-5. For the complete DSM-5 see Diagnostic and Statistical Manualof Mental Disorders, 5th edn. 2013,

More information

What is dementia? What is dementia?

What is dementia? What is dementia? What is dementia? What is dementia? What is dementia? Dementia is an umbrella term for a range of progressive conditions that affect the brain. There are over 200 subtypes of dementia, but the five most

More information

Navigating The Cognitive Internet: Introduction. Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System

Navigating The Cognitive Internet: Introduction. Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System Navigating The Cognitive Internet: Introduction Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System What s so hard about diagnosing dementia? Diagnosis relies on synthesis

More information

Presenter Disclosure Information. I have no financial relationships to disclose:

Presenter Disclosure Information. I have no financial relationships to disclose: Sandra Weintraub, Ph.D. Cognitive Neurology and Alzheimer s Disease Center Northwestern University, Feinberg School of Medicine Chicago, Illinois http://www.brain.northwestern.edu/dementia/ppa/index.html

More information

Stephen Salloway, M.D., M.S. Disclosure of Interest

Stephen Salloway, M.D., M.S. Disclosure of Interest Challenges in the Early Diagnosis of Alzheimer s Disease Stephen Salloway, MD, MS Professor of Neurology and Psychiatry Alpert Medical School, Brown University 2 nd Annual Early Alzheimer s Educational

More information

DIFFERENTIAL DIAGNOSIS SARAH MARRINAN

DIFFERENTIAL DIAGNOSIS SARAH MARRINAN Parkinson s Academy Registrar Masterclass Sheffield DIFFERENTIAL DIAGNOSIS SARAH MARRINAN 17 th September 2014 Objectives Importance of age in diagnosis Diagnostic challenges Brain Bank criteria Differential

More information

What is dementia? What is dementia?

What is dementia? What is dementia? What is dementia? What is dementia? What is dementia? Dementia is an umbrella term for a range of progressive conditions that affect the brain. It has been identified that there are over 200 subtypes of

More information

Caring Sheet #11: Alzheimer s Disease:

Caring Sheet #11: Alzheimer s Disease: CARING SHEETS: Caring Sheet #11: Alzheimer s Disease: A Summary of Information and Intervention Suggestions with an Emphasis on Cognition By Shelly E. Weaverdyck, PhD Introduction This caring sheet focuses

More information

Memory Loss, Dementia and Alzheimer's Disease: The Basics

Memory Loss, Dementia and Alzheimer's Disease: The Basics Memory Loss, Dementia and Alzheimer's Disease: The Basics What is memory loss? What is age-related memory loss? Typical changes Typical age-related changes involve: Making a bad decision once in a while

More information

Common Forms of Dementia Handout Package

Common Forms of Dementia Handout Package Common Forms of Dementia Handout Package Common Forms of Dementia 1 Learning Objectives As a result of working through this module, you should be better able to: 1. Describe clinical features of 4 major

More information

Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for Clinical Practice. Hypothesized Key Players in the Pathogenesis of AD

Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for Clinical Practice. Hypothesized Key Players in the Pathogenesis of AD AD is a Neurodegenerative Disease as Seen in the PET Scan and is Characterized by Amyloid Plaques and Neurofibrillary Tangles Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for

More information

Objectives. RAIN Difficult Diagnosis 2014: A 75 year old woman with falls. Case History: First visit. Case History: First Visit

Objectives. RAIN Difficult Diagnosis 2014: A 75 year old woman with falls. Case History: First visit. Case History: First Visit Objectives RAIN Difficult Diagnosis 2014: A 75 year old woman with falls Alexandra Nelson MD, PhD UCSF Memory and Aging Center/Gladstone Institute of Neurological Disease Recognize important clinical features

More information

Dementia and Alzheimer s disease

Dementia and Alzheimer s disease Since 1960 Medicine Korat โรงพยาบาลมหาราชนครราชส มา Dementia and Alzheimer s disease Concise Reviews PAWUT MEKAWICHAI MD DEPARTMENT of MEDICINE MAHARAT NAKHON RATCHASIMA HOSPITAL 1 Prevalence Increase

More information

LANGUAGE AND PATHOLOGY IN FRONTOTEMPORAL DEGENERATION

LANGUAGE AND PATHOLOGY IN FRONTOTEMPORAL DEGENERATION LANGUAGE AND PATHOLOGY IN FRONTOTEMPORAL DEGENERATION Murray Grossman University of Pennsylvania Support from NIH (AG17586, AG15116, NS44266, NS35867, AG32953, AG38490), IARPA, ALS Association, and the

More information

Update on functional brain imaging in Movement Disorders

Update on functional brain imaging in Movement Disorders Update on functional brain imaging in Movement Disorders Mario Masellis, MSc, MD, FRCPC, PhD Assistant Professor & Clinician-Scientist Sunnybrook Health Sciences Centre University of Toronto 53 rd CNSF

More information

Dementia and Healthy Ageing : is the pathology any different?

Dementia and Healthy Ageing : is the pathology any different? Dementia and Healthy Ageing : is the pathology any different? Professor David Mann, Professor of Neuropathology, University of Manchester, Hope Hospital, Salford DEMENTIA Loss of connectivity within association

More information

An integrated natural disease progression model of nine cognitive and biomarker endpoints in patients with Alzheimer s Disease

An integrated natural disease progression model of nine cognitive and biomarker endpoints in patients with Alzheimer s Disease An integrated natural disease progression model of nine cognitive and biomarker endpoints in patients with Alzheimer s Disease Angelica Quartino 1* Dan Polhamus 2*, James Rogers 2, Jin Jin 1 212, Genentech

More information

Clinicopathologic and genetic aspects of hippocampal sclerosis. Dennis W. Dickson, MD Mayo Clinic, Jacksonville, Florida USA

Clinicopathologic and genetic aspects of hippocampal sclerosis. Dennis W. Dickson, MD Mayo Clinic, Jacksonville, Florida USA Clinicopathologic and genetic aspects of hippocampal sclerosis Dennis W. Dickson, MD Mayo Clinic, Jacksonville, Florida USA The hippocampus in health & disease A major structure of the medial temporal

More information

Ruolo dei biomarcatori come criterio di supporto nella diagnostica delle demenze ad esordio precoce

Ruolo dei biomarcatori come criterio di supporto nella diagnostica delle demenze ad esordio precoce Ruolo dei biomarcatori come criterio di supporto nella diagnostica delle demenze ad esordio precoce ALESSANDRO MARTORANA UOC NEUROLOGIA-CENTRO ALZHEIMER POLICLINICO TOR VERGATA-UNIVERSITÀ DI ROMA TOR VERGATA

More information

Confronting the Clinical Challenges of Frontotemporal Dementia

Confronting the Clinical Challenges of Frontotemporal Dementia Confronting the Clinical Challenges of Frontotemporal Dementia A look at FTD s symptoms, pathophysiology, subtypes, as well as the latest from imaging studies. By Zac Haughn, Senior Associate Editor Ask

More information

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics. DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this

More information

Imaging of Alzheimer s Disease: State of the Art

Imaging of Alzheimer s Disease: State of the Art July 2015 Imaging of Alzheimer s Disease: State of the Art Neir Eshel, Harvard Medical School Year IV Outline Our patient Definition of dementia Alzheimer s disease Epidemiology Diagnosis Stages of progression

More information

Pathogenesis of Degenerative Diseases and Dementias. D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria)

Pathogenesis of Degenerative Diseases and Dementias. D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria) Pathogenesis of Degenerative Diseases and Dementias D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria) Dementias Defined: as the development of memory impairment and other cognitive deficits

More information

Alzheimer s Disease without Dementia

Alzheimer s Disease without Dementia Alzheimer s Disease without Dementia Dr Emer MacSweeney CEO & Consultant Neuroradiologist Re:Cognition Health London Osteopathic Society 13 September 2016 Early diagnosis of Alzheimer s Disease How and

More information

Dementia: Diagnosis and Treatment

Dementia: Diagnosis and Treatment Dementia: Diagnosis and Treatment Outline 1. Risk factors and definition of dementia 2. Types of Dementias 3. MMSE and testing 4. Treatment options Cognitive decline with aging Mild changes in memory and

More information

OLD AGE PSYCHIATRY. Dementia definition TYPES OF DEMENTIA. Other causes. Psychiatric disorders of the elderly. Dementia.

OLD AGE PSYCHIATRY. Dementia definition TYPES OF DEMENTIA. Other causes. Psychiatric disorders of the elderly. Dementia. Psychiatric disorders of the elderly OLD AGE PSYCHIATRY Dementia Depression Delusional disorder/late onset schizophrenia Delirium Dementia definition LOCALISATION OF CEREBRAL FUNCTION Impairment of multiple

More information

Parkinson Disease. Lorraine Kalia, MD, PhD, FRCPC. Presented by: Ontario s Geriatric Steering Committee

Parkinson Disease. Lorraine Kalia, MD, PhD, FRCPC. Presented by: Ontario s Geriatric Steering Committee Parkinson Disease Lorraine Kalia, MD, PhD, FRCPC Key Learnings Parkinson Disease (L. Kalia) Key Learnings Parkinson disease is the most common but not the only cause of parkinsonism Parkinson disease is

More information

DEMENTIA. Szabolcs Szatmári. Tg. Mureş Marosvásárhely Romania 4/18/ :59 AM

DEMENTIA. Szabolcs Szatmári. Tg. Mureş Marosvásárhely Romania 4/18/ :59 AM DEMENTIA Szabolcs Szatmári Tg. Mureş Marosvásárhely Romania Dementia from Latin de- "apart, away" + mens (genitive mentis) "mind" MORE GRAY HAIR AND LESS GRAY MATTER Daryl R. Gress Cognitive decline

More information

The Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing

The Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing The Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing. (AUSTRALIAN ADNI) July 2012 UPDATE Imaging Christopher Rowe MD Neuroimaging stream leader October 2011 The Australian Imaging Biomarkers

More information

What is dementia? Symptoms of dementia. Memory problems

What is dementia? Symptoms of dementia. Memory problems What is dementia? What is dementia? What is dementia? Dementia is an umbrella term for a range of progressive conditions that affect the brain. The brain is made up of nerve cells (neurones) that communicate

More information

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER FOURTEEN CHAPTER OUTLINE. Dementia, Delirium, and Amnestic Disorders. Oltmanns and Emery

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER FOURTEEN CHAPTER OUTLINE. Dementia, Delirium, and Amnestic Disorders. Oltmanns and Emery ABNORMAL PSYCHOLOGY SEVENTH EDITION Oltmanns and Emery PowerPoint Presentations Prepared by: Ashlea R. Smith, Ph.D. This multimedia and its contents are protected under copyright law. The following are

More information

The Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing an example of Australian research on Alzheimer s disease

The Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing an example of Australian research on Alzheimer s disease The Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing an example of Australian research on Alzheimer s disease AIBL: Two site collaborative study Study is conducted at two sites: Perth

More information

Diagnosis and management of Dementia

Diagnosis and management of Dementia Diagnosis and management of Dementia Dr. Jahnavi Kedare Associate Professor Dept. of Psychiatry, T. N. Medical College B. Y. L. Nair Hospital, Mumbai Prevalence of Dementia Lower than developed countries

More information

ALZHEIMER S DISEASE OVERVIEW. Jeffrey Cummings, MD, ScD Cleveland Clinic Lou Ruvo Center for Brain Health

ALZHEIMER S DISEASE OVERVIEW. Jeffrey Cummings, MD, ScD Cleveland Clinic Lou Ruvo Center for Brain Health ALZHEIMER S DISEASE OVERVIEW Jeffrey Cummings, MD, ScD Cleveland Clinic Lou Ruvo Center for Brain Health Prevalence AD: DEMOGRAPHY AND CLINICAL FEATURES Risk and protective factors Clinical features and

More information

3/7/2017. Alzheimer s and Dementia Research: An Advanced Discussion. Alzheimer s and Dementia Research: An Advanced Discussion

3/7/2017. Alzheimer s and Dementia Research: An Advanced Discussion. Alzheimer s and Dementia Research: An Advanced Discussion Alzheimer s and Dementia Research: An Advanced Discussion Brad Boeve, MD Department of Neurology Mayo Clinic Alzheimer s and Dementia Research: An Advanced Discussion Theoretical Constructs in Aging/Dementia

More information