ID 110440
タイトルヨミ
チホウ ノ キホンテキナ ミカタ
タイトル別表記
Approach to diagnosis of dementia
著者
大塚, 智丈 高瀬町立西香川病院精神科
キーワード
dementia
diagnosis
history
資料タイプ
学術雑誌論文
抄録
Dementia is characterized by an acquired and generalized impairement of cognitive function that interferes with daily and social activities with no disturbance of consciousness. This disorder is becoming progressively more common. However, it is not easy to diagnose and treat it. The patients with dementia are often not aware of their problems well. Therefore, the history should be obtained from family members or other informants, in addition to interviewing the patients with cognitive decline. The clinician needs to take the history sufficiently and also get information about the conditions of family such as their availability and ability to help. The mode of onset and time course of deterioration are specially important in differential diagnosis. Whether the patient has dementia is determined by the history, degree of cognitive dysfunction on mental state examination, general physical examination including neurological assessment, and laboratory investigations. Dementia should be carefully differentiated from delirium, depressive disorder, and the other psychotic disorders. The history is most useful in distinguishing dementia from the others. The onset of delirium is rapid, while that of dementia is usually slow. The symptoms of delirium tend to fluctuate and often become worse at night. But dementia and delirium frequently coexit, and the differentiation may be difficult in this case. In depressive disorder, usually a history of mood disturbance precedes the other symptoms. Patients with depression typically respond not incorrectly but incompletely to questions, for example, "I don't know". Some types of dementia are reversible or remediable. Therefore, it is most important not to miss any treatable dementia, such as subdural hematoma and normal pressure hydrocephalus. Vascular dementia and Alzheimer's disease are predominant types of dementia among the elderly. It is also important to differentiate these two diseases for proper treatment and care.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
56
2
開始ページ
46
終了ページ
50
並び順
46
発行日
2000-04-25
フルテキストファイル
言語
jpn
著者版フラグ
出版社版