Review Article

Alzheimer's Disease Clinical and Research Update for Health Care Practitioners

Table 1

Diagnostic assessment for dementia.

(i) Initial exam
(signs to look for)
 Poor orientation
 Increased forgetfulness
 Confusion in ADLs and IADLs
 Language perseverations and circumlocutions
 Change in personality and emotional status
 Avoidance of typical activities and hobbies
 Social isolation
(ii) Mental status screening-use NIAA criteria
(example of evaluation tools that may be used)
 Mini mental state
 Clock drawing
 Mattis dementia screening
 Montreal cognitive assessment
 Clinical dementia rating scale
 Geriatric depression scale
(iii) Interview for instrumental activities of daily living
(observations by family or caregiver report)
 Medication use
 Cooking
 Driving
 Financial management
(iv) Interview for general activities of daily living
(observations by family or caregiver report)
 Bathing
 Dressing
 Toileting
(v) Assessment of visual motor skills
(signs to look for)
 Ideomotor apraxia (skilled movement to verbal  
 command or initiation)
 Ideational apraxia (performing a planned series  
 of tasks to achieve a goal)
 Extrapyramidal motor signs
 Constructional apraxia
 Spatial conceptualization errors
(vi) Neuroimaging
 CT
 SPECT
 MRI
 PET
(vii) Neuropsychological testing
(skill areas to assess)
 Estimate of premorbid IQ
 Attention
 Processing speed
 Executive functioning
 Planning, organization, mental flexibility
  Memory
   Working memory
   Immediate recall
   Delayed recall
   Long term memory
  Language
   Naming
   Semantic fluency
   Evidence of perseverations
   Evidence of circumlocution