Magazine article Clinical Psychiatry News

Office-Based History, Testing Can Help Diagnose Dementia

Magazine article Clinical Psychiatry News

Office-Based History, Testing Can Help Diagnose Dementia

Article excerpt

BOSTON--Taking a good history and administering a brief cognitive screening test can go a long way toward identifying Alzheimer's disease and other dementias, according to one family physician.

Currently, too many patients with mild to moderate dementia--patients with significant functional impairment--are being missed in the office, according Dr. Kathleen R. Soch, associate professor in the department of family and community medicine at the Texas A&M Health Science Center in Corpus Christi.

But physicians can improve their track records by following a few simple steps: take a complete history, administer the Folstein Mini Mental Status Exam (FMMSE), rule out depression, perform routine laboratory testing, and consider ordering an imaging study, she said at the annual meeting of the American Academy of Family Physicians.

Most physicians know to ask patients and their family members about memory loss, Dr. Soch said, but they do not realize that family members often overlook problems with memory. A family caregiver may think their parent's memory loss is normal for their age and that they are doing well, when in fact the memory impairment could be significant, she said. In those cases, families often come to the office because of the behavioral problems sometimes seen in dementia patients. When taking a history, consider other symptoms such as aphasia, apraxia, agnosia, and problems with executive function.

For patients with symptoms of dementia, Dr. Soch recommends using the FMMSE as a screening tool. The test is one of the most widely used screening tests. It takes less than 10 minutes to complete in the office, and physicians can administer it themselves or train someone else in the office to do it, she said.

The FMMSE is a 30-point test that asks patients to identify where they are, the date and season, repeat words they have heard, recall words, spell a word backward, demonstrate simple language skills, and perform simple tasks. …

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