The Rational Clinical Examination
David L. Simel, Drummond Rennie
Dementia
David L. Simel
Make the Diagnosis: Dementia
Topics Discussed:
cognition disorders, criterion standard comparisons (diagnostic tests), dementia, diagnostic process, likelihood ratio, memory disorders, mini-mental status examination (mmse), prior probability, questionnaires, reference standards
Excerpt:
"Dementia consists of multiple cognitive deficits that include
memory impairment and at least 1 of the following cognitive disturbances:
agnosia, aphasia, apraxia, or a disturbance in executive functioning
(see Box 63-1). Overall, the prevalence of dementia among patients
65 years or older is 6%-16%. This prior probability
can be refined by recognizing that age is the most important risk
factor for dementia. Dementia exists in only 1% of patients
in the sixth decade of life, but the prevalence doubles every 5
years so that by age 90 about 39% of elders are affected. ..."
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