I. DSM-IV Diagnostic Criteria for Dementia
A. The development of multiple cognitive deficits manifested by:
1. Memory impairment
2. One or more of the following:
a. Aphasia (language disturbance).
b. Apraxia (impaired ability to carry out purposeful movement, especially the use of objects).
c. Agnosia (failure to recognize or identify objects).
d. Disturbance in executive functioning (abstract thinking, planning and carrying out tasks).
B. The cognitive deficits cause significant social and occupational impairment and represent a significant decline from a previous level of functioning.
C. The deficits are not the result of delirium.
A. The memory impairment involves difficulty in learning new material and/or forgetting previously learned material. Early signs may consist of losing belongings or getting lost more easily.
B. Once the dementia is well established, patients may have great difficulty performing activities of daily living such as bathing, dressing, cooking, or shopping.
C. Poor insight and impaired judgment are common features of dementia.
1. Patients are often unaware of their deficits.
2. Patients may overestimate their ability to safely carry out specific tasks.
3. Disinhibition can lead to poor social judgment, such as making inappropriate comments.
D. Psychiatric symptoms are common and patients frequently manifest symptoms of anxiety, depression, and sleep disturbance.
E. Paranoid delusions (especially accusations that others are stealing items which are lost) and hallucinations (especially visual) are common.
F. Delirium is frequently superimposed upon dementia because these patients are more sensitive to the effects of medications and physical illness.
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