Dementia
20
STEP 7: Perform a mental status evaluation
➤ Can be repeated yearly to document progression in long-term care.
Remember to normalize score based on education.
STEP 6: Assess functional capacity
Table 5. Common Types of Dementia
History Physical Exam
Frontotemporal
dementia
Progressive loss of memory
with an early change in
behavior such as disinhibition,
inappropriate social awareness,
loss of sympathy/empathy,
repetitive or compulsive
behaviors, and personality
changes. Also see increasing
apathy and possible dietary
changes or binge eating.
Unremarkable
Parkinson's disease
dementia
Loss of memory, executive
function. Usually seen at the
end of Parkinson's disease
course.
Prominent features of
parkinsonism, tremors, rigidity,
gait disturbances
Vascular dementia Usually a stepwise
deterioration in cognitive
function. May not be
progressive. Associated
with a decrease in functional
status. Prior imaging studies
may show evidence of old
strokes, ischemic, lacunar,
hemorrhagic. Other imaging
studies may show evidence of
small vessel disease or amyloid
angiopathy.
Can present with focal
neurological signs depending
on area of brain involved.
Table 6. Activities of Daily Living
ADLs IADLs
• Bathing
• Dressing
• Transferring
• Toileting
• Continence
• Feeding
• Finance management
• Use of telephone
• Ability to go shopping
• Self-administration of medications
• Performing laundry and other
household shores
