Acquired progressive decline in two or more cognitive domains causing functional impairment, without delirium.
Causes
- • Alzheimer's disease
- • Vascular dementia
- • Dementia with Lewy bodies
- • Frontotemporal dementia
- • Mixed pathology
Investigations
- • Cognitive testing (MoCA/ACE-III)
- • Bloods: FBC, U&E, LFT, TFT, B12, folate, calcium, glucose, HIV/syphilis if indicated
- • CT/MRI brain
- • Consider FDG-PET or DaTscan for atypical cases
Management
- • Cholinesterase inhibitor (donepezil/rivastigmine) in Alzheimer's and DLB
- • Memantine for moderate-severe disease
- • Non-pharmacological first for BPSD
- • Advance care planning, carer support, driving advice
Clinical pearls
- • Antipsychotics increase stroke and death risk in dementia — avoid in DLB especially
- • Always exclude delirium and depression (pseudodementia)
Related in WardRound
Educational — verify locally.
