Major neurocognitive disorders (MNCD): Diagnosis and workup 1) Clinical diagnosis Cognitive impairment + loss of autonomy 2) Rule out treatable conditions (1.5%) : tumors, hematoma, hydrocephalus, HIV, syphilis, Whipple, vitamin deficiency, ... laboratory tests + imaging 3) Perform the diagnostic workup What type of MNCD ? MRI, iADL scale, MMSE, neuropsychological assessment Alzheimer - 1st cause after 65 years - Progressive amnesia and impaired executive functions - Aphaso-apraxo-agnosia syndrome - Hippocampal atrophy Lewy body dementia - Visual hallucinations - Movement disorders (parkinsonian signs) - Behavioral changes, sleep difficulties - Fluctuating cognition (attention and altertness) Frontotemporal dementia - Behavioral changes (disinhibition, compulsive behavior, hyperorality, - 25% genetic component - Frontal atrophy Vascular Dementia - 2nd cause after 65 yrs - Subacute onset with step-wise decline > progressive - Loss of bladder control - Unique or multiple ischemic stroke - Amyloid angiopathy By Dr. Amandine Dessertennes via Dr. Benjamin Terrier @TerrierBen #MNCD #Dementia #Differential #Subtypes #Classification #Workup #Diagnosis #Geriatrics #Workup
