J Korean Diabetes.  2012 Sep;13(3):133-139.

Clinical Diagnosis of Dementia

• Choi SH

Abstract

Cognitive function, behavioral symptoms, and activities of daily living (ADL) are all evaluated for a diagnosis of dementia. The Samsung Dementia Questionnaire (SDQ), the Short form-SDQ (S-SDQ), and the Korean Dementia Screening Questionnaire (K-DSQ) are all useful tools in the evaluation of cognitive function. The mini-mental state examination (MMSE) is the most popular tool for the measurement of general cognitive function. Objective cognitive impairment needs to be defined using neuropsychological tests. ADLs are evaluated by interview and an ADL scale such as the Korean Instrumental ADL (K-IADL) or the Seoul-IADL. Abnormal behavioral symptoms can be efficiently evaluated using the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). The severity of dementia can be evaluated using the Clinical Dementia Rating scale or the Global Deterioration Scale. To determine the cause of dementia, neurologic examination, structural brain imaging, and blood testing, including VDRL, Vitamin B12, folate, and thyroid function tests, are administered. The new diagnosis of dementia due to Alzheimer's disease (AD) by the National Institute on Aging-Alzheimer's Association was centered on a clinical core of insidious onset and worsening of episodic memory impairment, but biomarker evidence was also integrated into the diagnosis of AD dementia for use in research setting.

Keyword

Dementia; Diagnosis; Activities of daily living; Biomarker

MeSH Terms

Activities of Daily Living
Alzheimer Disease
Behavioral Symptoms
Dementia
Folic Acid
Hematologic Tests
Mass Screening
Memory, Episodic
Neuroimaging
Neurologic Examination
Neuropsychological Tests
Surveys and Questionnaires
Thyroid Function Tests
Vitamin B 12
Folic Acid
Vitamin B 12

Figure

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  Fig. 1 Brain magnetic resonance imaging of a 77-year old woman with Alzheimer's disease. T1-weighted coronal images shows bilateral medial temporal lobe atrophy.

Reference

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 1994. 4th ed. Washington, DC: American Psychiatric Association;143–146.

2. Park J, Ko HJ, Park YN, Jung CH. Dementia among the elderly in a rural Korean Community. Br J Psychiatry. 1994. 164:796–801.

3. Woo JI, Lee JH, Yoo KY, Kim CY, Kim YI, Kim CY. Prevalence estimation of dementia in a rural area of Korea. J Am Geriatr Soc. 1998. 46:983–987.

4. Kim DH, Na DL, Yeon BG, Kang Y, Min KB, Lee SH, Lee SS, Lee MR, Pyo OJ, Park CB, Kim S, Bae SS. Prevalence of Dementia in the Elderly of an Urban Community in Korea. Korean J Prev Med. 1999. 32:306–316.

5. Statistics Korea. A census of the population in 2005 [Internet]. 2005. cited 2012 Sep 30. Seoul: Statistics Korea;Available from: http://kostat.go.kr.

6. Kang SJ, Jeong Y, Lee BH, Baek MJ, Kwon JC, Chin J, Na DL. How early are initial symptoms recognized in Korean patients with Alzheimer's disease? Int J Geriatr Psychiatry. 2004. 19:699–700.

7. Choi SH, Na DL, Kang Y, Lee WY, Park BJ. The validity and reliability of the Samsung Dementia Questionnaire. J Korean Neurol Assoc. 1998. 16:307–314.

8. Choi SH, Na DL, Oh KM, Park BJ. A Short form of the Samsung Dementia Questionnaire ( S-SDQ ): development and cross-validation. J Korean Neurol Assoc. 1999. 17:253–258.

9. Yang DW, Cho B, Chey JY, Kim SY, Kim BS. The development and validation of Korean Dementia Screening Questionnaire (KDSQ). J Korean Neurol Assoc. 2002. 20:135–141.

10. Kwon YC, Park JH. A validation study of Korean version of Mini-Mental State Examination (MMSE-K). J Korean Neuropsychiatr Assoc. 1989. 28:125–135.

11. Kang Y, Na DL, Han HS. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997. 15:300–308.

12. Ahn HJ, Chin J, Park A, Lee BH, Suh MK, Seo SW, Na DL. Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci. 2010. 25:1071–1076.

13. Lee DY, Lee KU, Lee JH, Kim KW, Jhoo JH, Kim SY, et al. A normative study of the CERAD neuropsychological assessment battery in the Korean elderly. J Int Neuropsychol Soc. 2004. 10:72–81.

14. Choi JY. Korean Dementia Rating Scale (K-DRS). 1998. Seoul: Hakjisa.

15. Kim H, Na DL. Normative data on the Korean version of the Boston Naming Test. J Clin Exp Neuropsychol. 1999. 21:127–133.

16. Kim H, Na DL. Korean Western Aphasia Battery (K-WAB). 2001. Seoul: Paradise.

17. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965. 14:61–65.

18. Kang SJ, Choi SH, Lee BH, Kwon JC, Na DL, Han SH, et al. The Reliability and Validity of the Korean Instrumental Activities of Daily Living (K-IADL). J Korean Neurol Assoc. 2002. 20:8–14.

19. Choi SH, Na DL, Lee BH, Kang SJ, Ha CK, Han SH, et al. Validation of the Korean version of the Bayer activities of daily living scale. Hum Psychopharmacol. 2003. 18:469–475.

20. Ku HM, Kim JH, Kwon EJ, Kim SH, Lee HS, Ko H, et al. A study on the reliability and validity of Seoul-Instrumental Activities of Daily Living(S-IADL). J Korean Neuropsychiatr Assoc. 2004. 43:189–199.

21. Suh GH. Development of the Korean Version of Disability Assessment for Dementia Scale(DAD-K) to Assess Function in Dementia. J Korean Geriatr Soc. 2003. 7:278–287.

22. Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E, Georgotas A. Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. J Clin Psychiatry. 1987. 48:Suppl 5. 9–15.

23. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory : comprehensive assessment of psychopathology in dementia. Neurology. 1994. 44:2308–2314.

24. Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong J, Ha CK. The Korean version of the Neuropsychiatric Inventory: A Scoring Tool of Neuropsychiatric Disturbance in Dementia Patients. J Korean Med Sci. 2000. 15:609–615.

25. Kang SJ, Choi SH, Lee BH, Jeong Y, Hahm DS, Han IW, et al. Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). J Geriatr Psychiatry Neurol. 2004. 17:32–35.

26. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004. 57:297–305.

27. Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiatry. 1988. 23:271–284.

28. Choi SH, Na DL, Lee BH, Hahm DS, Jeong JH, Yoon SJ, et al. Dementia Research Group. Estimating the Validity of the Korean Version of Expanded Clinical Dementia Rating (CDR) Scale. J Korean Neurol Assoc. 2001. 19:585–591.

29. Choi SH, Na DL, Lee BH, Halm DS, Jeong JH, Jeong Y, et al. The validity of the Korean version of Global Deter iorat ion Scale. J Korean Neurol Assoc. 2002. 20:612–617.

30. Motter R, Vigo-Pelfrey C, Kholodenko D, Barbour R, Johnson-Wood K, Galasko D. Reduction of beta-amyloid peptide42 in the cerebrospinal fluid of patients with Alzheimer's disease. Ann Neurol. 1995. 38:643–648.

31. Klunk WE, Engler H, Nordberg A, Wang Y, Blomqvist G, Holt DP, et al. Imaging brain amyloid in Alzheimer's disease with Pittsburgh Compound-B. Ann Neurol. 2004. 55:306–319.

32. Vandermeeren M, Merckem M, Vanmechelen E, Six J, van de Voorde A, Martin JJ, et al. Detection of tau proteins in normal and Alzheimer's disease cerebrospinal fluid with a sensitive sandwich enzyme-linked immunosorbent assay. J Neurochem. 1993. 61:1828–1834.

33. Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, et al. Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry. 1992. 55:967–972.

34. Coleman RE. Positron emission tomography diagnosis of Alzheimer's disease. Neuroimaging Clin N Am. 2005. 15:837–846.

35. McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011. 7:263–269.