Dementia
Clinicians should be alert to the symptoms and signs of dementia in people over 65 years of age. These may be detected opportunistically using questions addressed to the person and/or their carer (C). Depression and dementia may co-exist. When a person has dementia, adequate support is required for the person, their carer and their family.163
| Who is at higher risk of dementia and depression? | What should be done? | How often? | Level of evidence and references |
|---|---|---|---|
| Average risk Those without symptoms |
No evidence of benefit from screening |
NA |
IIC 131 |
Increased risk
|
Case finding and early intervention |
NA |
IIIC 132 |
High risk
|
Case find if suspected, as early intervention, comprehensive assessment and support helps Patients who complain of memory loss are more likely to have depression than dementia |
Opportunistically |
IV C 133 II B |
| Intervention | Technique | References |
|---|---|---|
| Case finding and confirmation | Ask: ‘How is your memory?’ Obtain information from others who know the person Over several consultations, obtain the history from the person and family/carer and perform a comprehensive physical examination. Undertake cognitive assessment using the Mini-Mental State Examination (MMSE), General Practitioner Assessment of Cognition (GPCOG) or clock drawing test.166 The Rowland Universal Dementia Assessment Scale (RUDAS) is a multicultural cognitive assessment scale used to detect dementia across different cultures. The MMSE is the most widely used and evaluated scale. Assess functional status; the Instrumental Activities of Daily Living (IADL) assessment tool may be used See also Chapter 10 Psychosocial |
|
| www.minimental.com/ www.dementia.unsw.edu.au www.alzheimers.org.au/content.cfm?infopageid=3955 www.abramsoncenter.org/PRI/documents/IADL.pdf |
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© The Royal Australian College of General Practitioners
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