Young Onset Dementia-Initial Assessment
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Transcript of Young Onset Dementia-Initial Assessment
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8/6/2019 Young Onset Dementia-Initial Assessment
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Young Onset Dementia- Initial Assessment
Presenting Problems
1 Memory related
2 Language related
3 Behavioural problems
4 Neurological Disorder
5 Basic ADLs
6 Instrumental ADLs
7
8
9
Vascular Risk factors
1 Diabetes Mellitus
2 Hypertension
3 Hypercholesterolemia
4 Smoking
5 h/o TIA
6 h/o CVA
7 Peripheral vascular Disease
8 Atrial Fibrillation
9 Valvular Heart Disease
10
11
12
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Neurological Problems
Parkinsons disease
Huntingtons disease
Multiple Sclerosis
Motor Neuron Disease
Progressive Supra Nuclear Palsy
CVA
Restless Leg Syndrome
Heavy metal Exposure
Hazardous occupation
Traumatic Brain Injury Mild, Moderate, Severe When? H/o hospitalisation, current support
network, previous cognitive assessment, medico legal /claims outstanding
Others
OTHER MEDICAL DISORDERS
Disorder Duration
MEDICATIONS
MEDICATION DOSE
1
2
34
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5
6
7
8
9
1011
12
Alcohol History
How many years
Typical drinking pattern
Binging or continuous drinking
Average drinks per dayNo of Units per week
Worst day
Withdrawal features
Tolerance
Physical complications cirrhosis, jaundice, peptic ulcer disease ,peripheral neuropathy,freq falls
Psychological complications
Inability to control
Period of abstinence if any
Psychiatric History
Psychosis
Depression
Anxiety Disorder
Bipolar Disorder
Alcohol/drug misuse
Personality Disorder
Others
Treatment received /receiving for any of the above
Current Psychiatric problems
1. Depression BDI, HADS, history +MSE
2. Psychosis BPRS, history +MSE
3. Anxiety Disorder HADS, history +MSE
4. Others - history +MSE
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Katz Index of Independence in Activities of DailyLiving
Activities
Points (1 or 0)
Independence
(1 Point)NO supervision, direction or
personal assistance
Dependence
(0 Points)WITH supervision, direction,
personal assistance or total
care
BATHING
Points: __________
(1 POINT) Bathes self
completely or needs help in
bathing only a single part of
the body such as the back,
genital area or disabled
extremity
(0 POINTS) Need help with
bathing more than one part of
the body, getting in or out of
the tub or shower. Requires
total bathing
DRESSING
Points: __________
(1 POINT) Get clothes from
closets and drawers and putson clothes and outer garments
complete with fasteners. May
have help tying shoes.
(0 POINTS) Needs help with
dressing self or needs to becompletely dressed.
TOILETING
Points: __________
(1 POINT) Goes to toilet, gets
on and off, arranges clothes,
cleans genital area without
help.
(0 POINTS) Needs help
transferring to the toilet,
cleaning self or uses bedpan
or commode.
TRANSFERRING
Points: __________
(1 POINT) Moves in and out
of bed or chair unassisted.
Mechanical transfer aids are
acceptable
(0 POINTS)Needs help in
moving from bed to chair or
requires a complete transfer.
CONTINENCE
Points: __________
(1 POINT) Exercises
complete self control over
urination and defecation.
(0 POINTS) Is partially or
totally incontinent of bowel or
bladder
FEEDING
Points: __________
(1 POINT) Gets food from
plate into mouth without help.
Preparation of food may be
done by another person.
(0 POINTS) Needs partial or
total help with feeding or
requires parenteral feeding.
Total Points: ________
Score of 6 = High, Patient is independent.
Score of 0 = Low, patient is very dependent.
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INSTRUMENTAL ACTIVITIES OF DAILY LIVING
SCALE (I.A.D.L.)
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Hospital Anxiety and Depression Scale (HADS)
Patients are asked to choose one response from the four given for each interview.
They should give an immediate response and be dissuaded from thinking too longabout their answers. The questions relating to anxiety are marked "A", and todepression "D". The score for each answer is given in the right column. Instructthe patient to answer how it currently describes their feelings.
A I feel tense or 'wound up':
Most of the time 3
A lot of the time 2
From time to time, occasionally 1
Not at all 0
AI get a sort of frightened feelingas if something awful is about tohappen:
Very definitely and quite badly 3
Yes, but not too badly 2
A little, but it doesn't worry me 1
Not at all 0
DI can laugh and see the funnyside of things:
As much as I always could 0
Not quite so much now 1
Definitely not so much now 2
Not at all 3
AWorrying thoughts go throughmy mind:
A great deal of the time 3
A lot of the time 2
From time to time, but not toooften
1
Only occasionally 0
D I feel cheerful:
Not at all 3
Not often 2
Sometimes 1
Most of the time 0
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AI can sit at ease and feelrelaxed:
Definitely 0
Usually 1
Not Often 2
Not at all 3
D I feel as if I am slowed down:
Nearly all the time 3
Very often 2
Sometimes 1
Not at all 0
AI get a sort of frightened feeling
like 'butterflies' in the stomach:
Not at all 0
Occasionally 1
Quite Often 2
Very Often 3
DI have lost interest in myappearance:
Definitely 3
I don't take as much care as I
should2
I may not take quite as much care 1
I take just as much care as ever 0
AI feel restless as I have to be onthe move:
Very much indeed 3
Quite a lot 2
Not very much 1
Not at all 0
DI look forward with enjoyment tothings:
As much as I ever did 0
Rather less than I used to 1
Definitely less than I used to 2
Hardly at all 3
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Scoring (add the As = Anxiety.Add the Ds = Depression). Thenorms below will give you an ideaof the level of Anxiety andDepression.
0-7 = Normal
8-10 = Borderline abnormal
11-21 = Abnormal
Reference:
Zigmond and Snaith (1983)
A I get sudden feelings of panic:
Very often indeed 3
Quite often 2
Not very often 1
Not at all 0
DI can enjoy a good book or radioor TV program:
Often 0
Sometimes 1
Not often 2
Very seldom 3