Differential Diagnosis of Dementias - Alzheimer's Association

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Pathologic Profiles of Dementias Pathologic Signs AD PDD DLB VaD bvFTD Neuritic plaques ●●● ● ●● - - NFTs ●●● ● ●● - - Cortical Lewy bodies ● ● ●● - - Subcortical Lewy bodies ● ●●● ●●● - - Ischemic damage ●● - - ●●● - Tau or TDP-43 inclusions - - - - ●●● Biochemical Deficit AD PDD DLB VD FTD Cholinergic ●●● ●●●● ●●● -/● - Dopaminergic ● ●●● ●●● - - - Generally absent ● Infrequent ●● Typical ●●● Hallmark Feature ●●●● Severe Deficit 1. Stahl SM. Stahl's essential psychopharmacology: neuroscientific basis and practical applications. 3rd ed, Fully rev. and expanded. ed. Cambridge ; New York: Cambridge University Press; 2008. 2. Geldmacher D. Alzheimer’s Disease. Textbook of Alzheimer disease and other dementias. 1st ed. Weiner MF, Lipton AM, eds. Washington, DC: American Psychiatric Pub.; 2009. 3. Tarawneh R, Galvin JE. Dementia with Lewy Bodies and other Synucleinopathies. Textbook of Alzheimer disease and other dementias. 1st ed. Weiner MF, Lipton AM, eds. Washington, DC: American Psychiatric Pub.; 2009. 4. Bird TD, Miller BL. Alzheimer’s disease and other dementias. Harrison’s Principles of Internal Medicine. 16th ed. Kasper DL, Braunwald E, Fauci, AS, et al., eds. New York, NY: McGraw-Hill; 2005. 5. Szoeke CE, Campbell S, Chiu E et al, Vascular Cognitive Disorder. Textbook of Alzheimer disease and other dementias. 1st ed. Weiner MF, Lipton AM, eds. Washington, DC: American Psychiatric Pub.; 2009. 6. Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. Sep 2011;134(Pt 9):2456-2477. 7. Bohnen NI, Kaufer DI, Ivanco LS, et al. Cortical cholinergic function is more severely affected in Parkinsonian dementia than in Alzheimer disease: an in vivo positron emission tomographic study. 28 Arch Neurol. 2003;60:1745-1748.
Current FDA-Approved Therapies AD PDD Number of Acetylcholinesterase Inhibitors 1 4 1 Number of NMDA Antagonists 1 1 0 • AD symptoms correlate with disruption of cholinergic circuits 2 • PDD is characterized by a larger cholinergic deficit than AD 3 • There are no FDA-approved medications of any class to treat DLB, VaD, or FTD 1. Fortinash KM, Holoday-Worret PA. Psychiatric Mental Health Nursing. 3rd ed. St. Louis, MO: Mosby; 2004. 2. Boyd M Psychiatric Nursing: Contemporary Practice. 4th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008. 3. Reisberg B et al. N Engl J Med. 2003;348(14):1333-1341. 29
Page 1 and 2: Differential Diagnosis of Dementias
Page 3 and 4: Differential Diagnosis of Dementias
Page 5 and 6: The Typical Dementia Scenario • P
Page 7 and 8: Clinical Evaluation for Dementia 1
Page 9 and 10: Delirium is a Reversible Cause of C
Page 11 and 12: Examples of Cognitive Assessment To
Page 13 and 14: The Informant Interview: The AD8
Page 15 and 16: Montreal Cognitive Assessment (MoCA
Page 17 and 18: Rapid Brief Cognitive Screens: Pros
Page 19 and 20: Core Clinical Alzheimer’s Dementi
Page 21 and 22: Core Clinical Dementia with Lewy Bo
Page 23 and 24: Frontotemporal Dementia • FTD may
Page 25 and 26: Imaging in the Diagnosis • Left -
Page 27: Neuropsychiatric Symptoms in Dement
Page 31 and 32: Caregiver Challenges in Different T

Differential Diagnosis of Dementias - Alzheimer's Association

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