DEMENTIA

• Most causes of dementia are irreversible BUT there are treatable causes

• Demented patients with an acute change in mental state should be assessed for causes of delerium

• See Causes for abnormal mental state

CAUSES

IRREVERSIBLE

• Senile dementia

• Alzheimer's dementia

• Multi-infarct dementia

REVERSIBLE

(see also Causes for delerium, Screening for organic illness in disturbed patients)

• Neurosurgical lesions - Normal pressure hydrocephalus, chronic subdural haematoma

• Nutritional/Vitamin deficiencies

INVESTIGATIONS - 'Dementia screen'

• FBC
• EUC +/- LFTs
• MSU

Most of these can be done on the ward:

• ESR
• HIV/Syphilis serology
• TFTs
• B12/Folate deficiency

If indicated:

CXR (if symptoms of infection or evidence of hypoxia)
CT Brain (if history of head trauma, focal neurology or cause not established)