A progressive clinical syndrome of deteriorating mental function affecting cognitive domains and social behavior
Dementia is a typically progressive clinical syndrome of deteriorating mental function significant enough to interfere with activities of daily living (ADLs). It affects cognitive domains (such as memory, thinking, language, orientation and judgement) and social behaviour (such as emotional control and motivation).
Key Point: Dementia diagnosis requires evidence of cognitive decline that interferes with independence in everyday activities.
Dementia can be difficult to identify as it usually has an insidious onset and non-specific signs and symptoms, which vary from person to person. People with early dementia may deny symptoms or accommodate to cognitive change and functional ability.
BPSD tend to fluctuate, may last for 6 months or more and include:
Classic Triad: Cognitive impairment + Urinary incontinence + Gait disorder
| Test | Purpose |
|---|---|
| Full blood count | Anemia, infection |
| ESR | Inflammatory conditions |
| Urea and electrolytes | Renal function, dehydration |
| Calcium | Hyper/hypocalcemia |
| HbA1c | Diabetes screening |
| Liver function tests | Liver disease |
| Thyroid function tests | Hypothyroidism |
| Serum B12 and folate | Vitamin deficiencies |
Referral: All patients with suspected dementia should be referred to a specialist memory assessment service for comprehensive evaluation and management.