_______________________________ Alzheimer Disease and Dementias: Early Detection and Care Planning
CONDITIONS AND EVENTS THAT MAY MIMIC DEMENTIA SYMPTOMS
Condition/Event
Symptom(s)
Polypharmacy
Confusion, memory problems, cognitive impairment Hypoxia (low oxygen levels), causing confusion and cognitive decline
Respiratory infection
Urinary tract infection
Acute confusion, agitation, hallucinations
Sleep disorder
Daytime sleepiness, memory problems, decreased cognitive function
Dehydration
Confusion, dizziness, cognitive impairment
Normal pressure hydrocephalus Metabolic/endocrine imbalance
Walking difficulties, urinary incontinence, cognitive decline Impaired cognitive function (particularly with thyroid disorders, diabetes)
Nutritional deficiencies (e.g., vitamin B12)
Memory loss, cognitive decline
Alcohol use
Cognitive impairment, memory problems Steady decline in overall mental function
Subdural hematoma
Poisoning/toxic exposure (heavy metals, pesticides)
Cognitive impairment
Anoxia
Cognitive impairment, somnolence
Source: Compiled by Author
Table 3
The American Psychological Association asserts that an interdisciplinary team is most likely to provide all the essential information necessary to make an accurate diagnosis of dementia and develop a comprehensive treatment plan.
DIAGNOSTIC PROCESS The diagnostic process for dementia involves several steps to ensure an accurate and comprehensive assessment. Initially, healthcare providers conduct a thorough medical history review and physical examination to rule out other potential causes of cognitive decline. This is followed by cognitive and neuropsychological testing to evaluate memory, problem- solving abilities, language skills, and other cognitive functions [12]. Imaging studies, such as MRI or CT scans, are often used to detect brain changes associated with dementia, while laboratory tests can help identify underlying conditions that may contribute to cognitive impairment. Table 4 provides more details on tests and examinations that may be used to diagnose Alzheimer disease. Healthcare providers play a crucial role in early detection of dementia. Primary care providers, neurologists, and geriatric specialists often notice early signs during routine check-ups or when patients present with memory concerns. They initiate the diagnostic process, coordinate care, and refer patients to specialists as needed. Additionally, they educate and support patients and families, helping them understand the diagnosis and navigate dementia care complexities [7].
(https://www.apa.org/practice/guidelines/guidelines- dementia-age-related-cognitive-change.pdf. Last accessed August 21, 2024.) Level of Evidence : Expert Opinion/Consensus Statement
ASSESSING COGNITION Assessment Tools
Cognitive assessment tools are crucial for diagnosing and moni- toring Alzheimer disease and other dementias. They evaluate cognitive domains like memory, attention, language, and executive function. Common tools include the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and clock drawing test (CDT) [15; 16; 17; 18]. The MMSE assesses orientation, registration, attention, calcu- lation, recall, language, and simple commands, scoring out of 30 points. Scores of 24–30 are normal, 18–23 indicates mild impairment, and 0–17 suggests severe impairment. The MoCA provides a comprehensive assessment, including visuospatial abilities, naming, memory, attention, language, abstraction,
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MDRI2026
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