Copy of Copy of Black Modern Minimalist Presentation (5).pdf

Copy of Copy of Black Modern Minimalist Presentation (5).pdf

1. Deter |
Dementia

Mild Cognitive
Impairment

2. 24 Outline

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D Deter _
Dementia

Objectives

Epidemiology

Clinical Assessment
Appropriate Investigations

Cognitive Impairment

3. 34 Objectives Dementia

O Differentiate normal aging from
MCI and dementia

O Be aware of criteria for MCI

O Have an approach to treatment
of MCI

4. Objectives Dementia

O Normal Memory for your age

May have minimal memory complaints but no
objective findings on clinical testing

O Mild cognitive impairment

Cognitive complaints with objective testing in
abnormal range (MMSE, RUDAS, MoCA, etc) but no
functional impact

© Dementia (i.e ‘Major
neurocognitive disorder’)

Cognitive complaints with functional decline

5. Dementia Stats Dementia

Age 85+
Canada: ~500,000 individuals
US: ~7 million

Europe: ~10 million
Expect this to double in 20 years

Tremendous societal cost

Direct healthcare costs, lost income of patient and
caregiver

6. Clinical Assessment Dementia

O History and collateral are
essential

O Physical examination helps with
differential
Mental status, parkinsonism, neurologic deficits ....

© Consider screening tools:
MMSE - most commonly used
MOCA - detecting MCI
RUDAS - culturally/linguistically diverse
Mini-Cog - very quick (<3mins)

7. Situation 1 Dementia

@ 72F with memory concerns

Has begun misplacing keys and other items - uses
post-it notes to keep track

Caregiver confirms that she continues to manage
the family business without any problems

O MoCA 25/30

Lost points: 1/5 delayed recall, 4/5 visuospatial

O Diagnosis?

8. Mild Cognitive Impairment Dementia

Also known as Mild Neurocognitive Disorder

@ Common
Approx 15% of individuals >70years old

O Pathology suggests
intermediate changes between
normal and AD

O Estimates of progression to
dementia
~10-15% annually

9. Mild Cognitive Impairment Dementia

Concern regarding change in
cognition

Impairment in one or more
cognitive domains

Memory, executive function, attention,
visuospatial, language

Independent functional activities

Do not meet criteria for dementia

10. 14 Effective Strategies

Deter .
Dementia

Physical Exercise

Cognitive Training (“Mental
exercise”)

Socialization

Healthy Food Choices

11. y Physical Exercise and Cognition Bementia

O Several studies showing benefit
on cognition and function

Meta-analysis (>2000 patients, 30 trials) - cognitive
function moderately improved

@ Evidence from high-quality RCTs
is lacking

12. 22 Brain Training

Deter _
Dementia

Quality of evidence limited but
consistent evidence of benefit

15 RCTs, >700 patients

Meta-analysis: Clear, consistent
benefit on cognition

Some improvement in QoL and communication

Variety of cognitive training
methods used

13. Deter

Socialization Dementia

Difficult area to formally study in scientific literature

Generally suggested and
indirect evidence from group
exercises/activities that
seem to benefit

14. y Dietary Strategies

Deter .
Dementia

Several studies show benefit of
Mediterranean-style diet

MIND diet - Excellent data to
support this

Very significantly reduced
incidence and progression of
dementia

15. Other Nonpharm Strategies Dementia

There are many other
nonpharm approaches with
proven effectiveness, including:
Optimizing sleep

Reviewing medications

Improving cardiovascular fitness

Assessing and managing sensory deficits (vision,
hearing, etc)

And many more that we explore
in depth at Deter Dementia

16. Deter

Recap Dementia

@ Differentiate normal aging from
MCI and dementia

Cognitive testing and Functional status

Be aware of criteria for MCI

Cognitive changes with functional independence

Have an approach to treatment
of MCI

Nonpharm strategies

17. |; DET
Dementia

Thank You

Benefits Of Becoming A Deter Dementia Member

+ Detalled, customized plan that evolves and improves as you do over time
+ Access to genetic testing to assess your risk

+ Neuropsychological assessments to establish your basoline and track improvement
+ One location for access to everything you need

www.deterdementia.com