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P3‐048: Potentially reversible causes of cognitive impairment: Two‐year data from a private sector memory clinic
Author(s) -
Srinivasan Srikanth
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1611
Subject(s) - dementia , dementia with lewy bodies , medicine , memory clinic , pediatrics , parkinsonism , normal pressure hydrocephalus , depression (economics) , psychiatry , neuropsychology , cognition , disease , economics , macroeconomics
Background: With a prevalence of 4 % over the age of 65 years dementia is a public health problem in Sri Lanka also Objective: To describe the clinical features of patients consecutively evaluated in a private sector neurologist’s memory clinic and to identify potentially reversible factors causing or contributing to the cognitive impairment Methods: Consecutive patients presenting to the clinic were administered cognitive screening [Concise Cognitive Test CONCOG] and neuropsychiatric tests [Neuropsychiatric Inventory Questionnaire], neuroimaging [CT or MRI] and serum vitamin B12 and Thyroid Stimulating Hormone assays. Neuropsychological assessments, other serum chemistries and CSF analysis were done where indicated. Dementia was diagnosed according to standard criteria. Results: A total of 110 patients were seen over 2 years and 106 completed the diagnostic evaluation. There were 26 patients with probable Alzheimer’s Disease [AD], 24 with probable Vascular dementia [VaD], 8 with mixed dementia, 8 with Dementia and Parkinsonism [PDD/DLB], 5 with Frontotemporal lobar degeneration [FTLD], 16 with Mild Cognitive Impairment [MCI], 5 with Normal Pressure Hydrocephalus [NPH], 9 with late onset depression [LOD] and 3 with late onset psychosis [LOP]. The mean(SD) CONCOG scores for each group were AD 13(4.0), VaD 15(3.7), Mixed dementia 14(3.4), PDD/DLB 20(5.2), NPH 15(4.6), MCI 22(2.2), LOD 24(3.4) and LOP 16(4.2). Of the total sample of 110 patients two each had low serum vitamin B12 and elevated TSH levels. In five out of 110 patients drugs such as anticholinergics [trihexyphenidyl, amitryptiline] and sedative-hypnotics were deemed to have worsened cognitive impairment. Conclusions: The majority of patients had irreversible dementia while 29 had potentially reversible causal or coincidental factors [depression, psychosis, NPH, low serum vitamin B12 and elevated TSH] contributing to their cognitive impairment.