Dementia
Alerts and Notices
Synopsis
Dementia is strongly associated with advanced age. Cognitive decline typically occurs slowly and progressively for years before a diagnosis is made. Affected patients may notice difficulty with or changes in their behavior, reasoning, remembering new information, directions, and complex tasks, but family members may be the first to recognize the extent of the patient's difficulties.
Etiology includes Alzheimer disease, dementia with Lewy bodies, Parkinson disease, brain injuries, brain tumors, and vascular disorders. Conventional risk factors for coronary artery disease are also associated with dementia.
Potential risks of onset of dementia before the age of 80 have been associated with exposure to strong anticholinergic drugs. These include certain medications for the treatment of depression and epilepsy as well as antiparkinson and bladder antimuscarinic drugs. Reducing exposure to these medications in patients who are middle-aged or elderly can help mitigate risk.
Dementia-like symptoms that occur with alcohol use disorder or certain drugs or medications may be
reversible. Otherwise, management is supportive.
Patients with this disorder may have an increased risk of various general medical conditions.
Related topic: frontotemporal lobar degeneration
Codes
ICD10CM:F03.90 – Unspecified dementia without behavioral disturbance
SNOMEDCT:
52448006 – Dementia
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Drug toxicity
- Medication-induced dementia symptoms
- Chronic ethanol consumption (ie, alcohol use disorder)
- Lead poisoning
- Carbon monoxide poisoning
- Multi-infarct dementia
- Depression
- Complex partial seizures
- Autoimmune encephalopathy
- Creutzfeldt-Jakob disease
- Syphilis
- HIV disease
- Vitamin B12 deficiency
- Hypothyroidism
- Normal pressure hydrocephalus
- Chronic subdural hematoma
- Hepatic encephalopathy
- Uremia
- Hypercalcemia
- Amyloid angiopathy
- Primary progressive aphasia
- Cortical basal ganglionic degeneration
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:06/20/2018
Last Updated:08/17/2021
Last Updated:08/17/2021