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Title:

DEMENTIA

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DEMENTIA Leena Patel GPSTR Overview Causes of dementia Differential diagnosis Dementia and QOF Degenerative diseases Alzheimer s Lewy body dementia Vascular Mixed ... – PowerPoint PPT presentation

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Title: DEMENTIA


1
DEMENTIA
  • Leena Patel
  • GPSTR

2
Overview
  • Causes of dementia
  • Differential diagnosis
  • Dementia and QOF

3
Degenerative diseases
  • Alzheimers
  • Lewy body dementia
  • Vascular
  • Mixed (e.g. Alzheimer's vascular)
  • Parkinsons disease
  • Huntingtons chorea
  • CJD
  • Picks disease

4
Treatable causes of Dementia
  • Vitamin lack
  • - B12, folic acid
  • Endocrine
  • - hypothyroidism
  • Normal pressure hydrocephalus
  • Severe anaemia
  • Renal Failure

5
Other causes of dementia
  • Traumatic
  • - severe head injury
  • Infections
  • - post encephalitis, HIV
  • Toxic
  • - alcohol
  • Space occupying lesion
  • - chronic subdural haematoma, intracranial
    tumour

6
Alzheimer's Vs Vascular
  • Alzheimers
  • - insidious decline
  • Progressive disorientation
  • Restless activity
  • insomnia
  • Decline in social behaviour
  • Dysphasia, dyspraxia
  • Vascular
  • step-wise decline
  • Episode of confusion
  • Seizures
  • Neurological signs

7
Lewy body Dementia
  • Progressive
  • Fluctuating course
  • Hallucinations (visual)
  • Delusions
  • Parkinsonism signs

8
Differential diagnosis
  • Functional or organic?
  • E.g.. Depressive pseudo dementia, dementia
    presenting as mood disorder
  • Delirium or dementia

9
Delirium Vs Dementia
  • Delirium
  • Acute
  • Fluctuates
  • Impaired consciousness
  • Thinking disorganised
  • Perceptual disturbances common
  • Impaired alertness
  • Dementia
  • Insidious
  • Stable/progressive
  • Normal consciousness
  • Impoverished thinking
  • Perceptual disturbance uncommon
  • Alert

10
QOF indicators for dementia
  • Practice can produce a register of pts diagnosed
    with dementia
  • Percentage of pts diagnosed with dementia whose
    care has been reviewed in the previous 15 months.

11
Dementia review template
  • Annual review
  • Discussion with carer (pt care needs, info)
  • Assessment of carer needs
  • Old age psychiatry referral

12
References
  • Psychiatry 2nd Edition Gelder, Mayou, Geddes
  • Quality and Outcomes Framework guidance for GMS
    contract 2009/2010
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