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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Dementia
Tracey Holsinger, Janie Deveau, Malaz Boustani, John W. Williams, Jr
Apraxia refers to the inability to perform a motor task despite intact motor function....


Topics Discussed: agnosia, alzheimer's disease, aphasia, apraxias, cognition disorders, delirium, dementia, diagnostic process, executive functioning, memory disorders, memory impairment, minimal cognitive impairment, questionnaires

Excerpt: "Dementia is a prevalent problem. Depending on how cases are defined, estimates of dementia prevalence can range from 2.4 million to 4.5 million individuals in the United States.1-4 In addition, many older adults notice difficulty with memory and other cognitive functioning.Dementia describes 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. The deficits that make up dementia can be diagnosed clinically. The deficits must be sufficient to cause functional impairment in home or work life and must represent a decline from previous functioning. A criterion standard diagnosis is established by a structured interview that follows the criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (Box 63-1).22..."
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