Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- memory loss
- disorientation
- nominal dysphasia
- misplacing items/getting lost
- apathy
- decline in activities of daily living and instrumental activities of daily living (IADLs)
- personality change
- unremarkable initial physical exam
Outros fatores diagnósticos
- mood and behavior changes
- poor abstract thinking
- constructional dyspraxia
- prosopagnosia
- autoprosopagnosia
Fatores de risco
- advanced age
- family history
- genetics
- Down syndrome
- cerebrovascular disease
- lifestyle factors and environment
- use of certain drugs
- less than high school education
- traumatic brain injury
- depression
- hearing loss
- periodontal disease
- visual impairment
- herpes simplex virus type 1 (HSV-1) infection
- hyperlipidemia
- female sex
- elevated plasma homocysteine level
- surgery under general anesthesia
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- cognitive testing
- CBC
- metabolic panel
- serum thyroid-stimulating hormone (TSH)
- serum vitamin B12
- urine drug screen
- CT brain (without contrast)
- MRI brain (without contrast)
Investigações a serem consideradas
- cerebrospinal fluid (CSF) analysis
- serum rapid plasma reagin/Venereal Disease Research Laboratory (VDRL)
- serum HIV testing
- formal neuropsychological testing
- genetic testing
- fluorodeoxyglucose-PET (FDG-PET)
- CSF biomarker testing
Novos exames
- amyloid-PET
- blood biomarkers
Algoritmo de tratamento
all patients
Colaboradores
Autores
Judith Neugroschl, MD
Associate Professor of Psychiatry
Alzheimer's Disease Research Center
Icahn School of Medicine at Mount Sinai
New York
NY
Declarações
JN participates in research funded by National Institutes for Health (NIH) grants. The Alzheimer's Disease Research Center is a site for clinical research but JN is not the site Principal Investigator, has no role in purchasing nor choosing the studies, and gains no compensation if it succeeds. JN helps to edit the Focus on Healthy Aging Alzheimer's yearly report.
Agradecimentos
Dr Judith Neugroschl would like to gratefully acknowledge Dr Brandy R. Matthews, Dr Asif S. Bhutto, and Dr Julie K. Gammack, the previous contributors to this topic.
Declarações
BRM, ASB, and JKG declare that they have no competing interests.
Revisores
Roy J. Goldberg, MD, FACP, AGSF, CMD
Medical Director
Kings Harbor Multicare Center
New York
NY
Declarações
RJG declares that he has no competing interests.
Philip Scheltens, MD, PhD
Professor of Neurology
Department of Neurology/Alzheimer Center
VU University Medical Center
Amsterdam
The Netherlands
Declarações
PS declares that he has no competing interests.
Referências
Principais artigos
Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing commission. Lancet. 2024 Aug 10;404(10452):572-628. Resumo
American College of Radiology. ACR appropriateness criteria: dementia. 2024 [internet publication].Texto completo
McShane R, Westby MJ, Roberts E, et al. Memantine for dementia. Cochrane Database Syst Rev. 2019 Mar 20;(3):CD003154.Texto completo Resumo
Birks JS, Chong LY, Grimley Evans J. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015 Sep 22;(9):CD001191.Texto completo Resumo
Birks JS, Harvey RJ. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2018 Jun 18;(6):CD001190.Texto completo Resumo
Reus VI, Fochtmann LJ, Eyler AE, et al. The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. Am J Psychiatry. 2016 May 1;173(5):543-6.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Delirium
- Depression
- Vascular dementia
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: dementia
- European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders
Mais DiretrizesFolhetos informativos para os pacientes
Alzheimer disease and other kinds of dementia
Caring for someone with dementia
Mais Folhetos informativos para os pacientesCalculadoras
Geriatric Depression Scale
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