50 year old women with memory deficit

Is it delirium?
Acute change in mental status + fluctuating
course
Inattention
Disorganized thinking or altered level of

Is it Post traumatic amnesia?

Happens after head trauma
Anterograde, retrograde, or both
Last hours, days, even months

No
Is it depresion?
Anxiety
Irritability
Happens after traumatic events (PTSD)
Unexplained physical complaints,
No worsing

Is there a reversible cause?

Encephalitis, hipotyroid, creatinine, electrolytes,

calcium, glucose, and vitamin B1 (korsakoff
Norm
al

Is it dementia, Mild cognitive impairment (MCI), or normal aging?

Dementia: objective findings of cognitive loss with

impairment of ADLs

LeeL,WestonWW,HeckmanG,GagnonM,LeeFJ,SlokaS.Structuredapproachtopatientswithmemory
difficultiesinfamilypractice.CanFamPhysician.2013Mar;59(3):24954.
 Female, 50 y.o. with memory deficit

Onset

Gradual Progressive

Onset can be Memory loss,

abrupt too especially for
Focal names and recent
neurological events
signs Language deficits
Signs of Rapid forgetting
vascular Impaired
disease visuospatial skills Insidious
Onset : onset, rapid
Normal gait and insidious,
neuro exam early progression
progressiv
Later affective Disinhibition
e with
disturbances Socially
fluctuation
behavioral s inappropriate
Strokes
symptoms such as behavior
Lacunar Fluctuatin
Poor judgment
infarcts g
cognitions Apathy,
White matter
Neurolepti decreased
lesions Imaging :
c motivation
Vulnerable to Generalized
sensitivity Poor executive
cerebrovascula atrophy ( esp.
Shuffling function
medial temporal )
Beta amyloid gait
plaques Increased
Vascular Dementia

Alzheimers disease Imaging :

Imaging : Frontal and
Generalize temporal
d atrophy atrophy
Lewy Pick cells and
bodies in pick bodies in
cortex and
midbrain
Frontotemporal

Lewy Body
Dementia