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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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Using Retinal Imaging to Study Dementia
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Evaluation of Suspected Dementia.

Nathan Falk1, Ariel Cole1, T Jason Meredith2

  • 1Florida Hospital Family Medicine Residency, Winter Park, FL, USA.

American Family Physician
|April 20, 2018
PubMed
Summary

Dementia affects millions, with numbers set to rise. Current guidelines suggest screening for cognitive impairment is not yet recommended due to insufficient evidence on benefits versus harms.

Area of Science:

  • Gerontology
  • Neurology
  • Public Health

Background:

  • Dementia is a major health concern affecting 5 million adults, and it is the fifth leading cause of death in Americans over 65.
  • The prevalence of dementia is projected to increase significantly as the population of older Americans doubles by 2060.

Purpose of the Study:

  • To review the current understanding of dementia, including risk factors and screening recommendations.
  • To outline diagnostic approaches for suspected cognitive impairment.

Main Methods:

  • Review of current literature and guidelines regarding dementia screening and diagnosis.
  • Identification of established risk factors for dementia.
  • Description of screening tools and diagnostic evaluations for cognitive impairment.

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Main Results:

  • Evidence is insufficient to recommend routine screening for cognitive impairment in older adults.
  • Several risk factors are associated with dementia, including age, family history, cardiovascular disease, diabetes, obesity, anticholinergic medication use, apolipoprotein E4 genotype, and lower education levels.
  • Physicians can utilize brief screening tests (e.g., Mini-Cog) for suspected dementia, followed by more in-depth assessments (e.g., Montreal Cognitive Assessment) if results are abnormal.

Conclusions:

  • While routine screening for cognitive impairment is not currently recommended, prompt evaluation is necessary if dementia is suspected.
  • Diagnostic testing should include screening for depression, relevant laboratory studies, and brain imaging when cognitive impairment is confirmed.
  • Routine cerebrospinal fluid testing and apolipoprotein E4 genetic testing are not advised.