diagnosis

1. is there cognitive impairment?

   • subjective
     • self reported
     • care reported
   • Objective

     • Cognitive tests - most screening but not diagnostic

       • cognitive toolkit on qhealth website
       • MMSE - has education and language bias
       • clockface
       • MOCA
       • bunch more
       • RUDAS and KIKA for remote and culturally diverse communities

       <aside> 💡 dementia pts try and rationalise answers if they dont know, depression say IDK

       </aside>

2. is the cognitive impairment caused by dementia?

   • progressive
   • interferes in everyday social or occupational activities
   • multiple cognitive domains affected
   • associated functional decline
     • think qualitative loss rather than binary
     • early: instrumental
     • late: self care
   • not due to another psychiatric/medica condition

Ddx

• depression
• delirium
• drugs
• Alzheimer's
• non Alzheimers
  • vascular dementia
  • DLB
  • fronto temporal dementias

mild cognitive impairment

• subjective memory complaints
• abnormal memory tests for age and educational level
• 15%/year progress to dementia

Caregiver burden in dementia

• psych: 50% risk depression
• social disruption
• physical: increase hosp risk, 70% increased prescription drug use
• financial: direct and indirect