The Singapore Family Physician

Back to issue Vol 35 No. 1 - Dementia Update 2009

Making the Diagnosis of Dementia

Chong Mei Sian
The Singapore Family Physician Vol 35 No 1 - Dementia Update 2009
66 - 72
1 January 2009
The prevalence of dementia is on a rising trend with the rapidly ageing population in Singapore. Hence, early diagnosis of dementia is important as early therapeutic interventions may palliate substantially, if not reverse, the significant emotional and economic costs of the illness. This is especially important in view of potential disease-modifying therapies in the pipeline, where treatment can then be initiated for those in the earliest stages of cognitive impairment, hence reducing the resultant morbidity and complications of the disease. In this paper, we present a 4-step approach to dementia evaluation, incorporating local data, where possible. The first step requires the exclusion of delirium as the cause of the forgetfulness or confusion. The second step involves establishing the diagnosis of dementia. The third step assesses for the behavioural, functional and social problems associated with dementia. The final step, with the use of a focused history, physical examination, investigations and selected use of neuroimaging, attempts to establish the aetiological diagnosis of the dementia.