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Making the Diagnosis of Dementia

 

In order to make an accurate diagnosis you must:

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  • rule out other conditions that may have similar symptoms as dementia but may be treatable e.g. hypothyroidism, depression, vitamin deficiencies etc.

  • rule out other possible causes of confusion such as poor vision or hearing, side effects of drugs etc.

An accurate diagnosis of dementia is important in order to:

  • implement an appropriate treatment plan

  • access information and support from the heath care system and the community support groups

  • assist the patient and family to plan and make arrangements for the future

Dementia is commonly under-diagnosed in primary health care settings because of the multiple etiologies and the wide range of symptoms at the time of presentation [1].

DSM-IV Diagnostic Criteria for Dementia

  • short term memory impairment (amnesia)

and at least one of:

  • language disturbance (aphasia)

  • impaired ability to carry out motor activities or ADLs (apraxia)

  • failure to recognize/identify familiar objects (agnosia)

  • poor executive functioning (planning, organizing, abstracting, disinhibition and inappropriate behaviour) [2]

 

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1. Dugue M, Neugroschl J, Sewell M, Marin D. Review of dementia. Mount Sinai Journal of Medicine 2003; 70:45-53.

2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM IV) 4th edition. Washington: The Association; 1994.

All references for this section