13/08/2025
Dementia 🧠
The most common causes are:
•Alzheimer disease
•vascular dementia
•a mixture of the 2
•Lewy body dementia
• frontotemporal dementia.
Dementia is also recognised as a complication of Parkinson disease.
Medication history is important to rule out drug-induced cognitive impairment. 💊 doctor 👩🏻⚕️
* Anticholinergic side effects of medications can lead to cognitive impairment. 😷
* Having multiple prescribers, a
common occurrence in elderly patients, is a risk factor for polypharmacy with anticholinergic agents.
Examples of drug classes commonly associated with anticholinergic
effects are:
1. Drugs used for nausea and vomiting e.g antiemetics/antivertigo agents
2. antihistamines
3. antimuscarinics, e.g., oxybutynin,
4. antipsychotics e.g., tricyclic antidepressants e.g.amitriptyline,
paroxetine
An association between the long-term use of benzos and dementia incidence has been demonstrated 💤
Physical examination is needed to identify the cause
Other tests:
Laboratory tests: CBC, electrolytes, kidney function, TSH, vitamin B12, calcium, blood glucose, Thiamine.
In order to assess for prodromal dementia or “very early Alzheimer disease without dementia,”
Study 📖: researchers have
attempted to use plasma and cerebrospinal fluid biomarkers (e.g. amyloid beta, tau protein)
❎Neuroimaging (usually CT head scan) if:
✔️60 years of age
✔️new onset
✔️rapid progression
✔️post-head injury
✔️focal or lateralizing signs
✔️history of cancer
✔️use of anticoagulants
✔️early urinary incontinence and gait disorder
✔️unusual cognitive symptoms
🙏🏼 Prevention of Dementia
Most clear evidence on the work done on dementia shows, especially in old age, the risk of dementia and cognitive decline is related to overall health.
It’s important for the general health be optimized.
🫀One important aspect of this is cardiovascular health; cardiovascular risk factors increase the chance of all causes of late-life dementia, including Alzheimer disease.
Evidence from t
