Dementia In Primary Care - Hurley Graduate Medical ….pptxVIP

Dementia and Decision-Making: Functional Assessment of the Older Adult IMyriam Edwards MD Geriatrician, Assistant Professor, andGeriatric Medicine Fellowship Program DirectorHurley Medical Center / Michigan State UniversityGeriatric Education Center of Michigan Geriatric Education Center of Michigan activities are supported by a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Public Health Service Act, Title VII, Section 753(a). This module was developed by Mark Ensberg, MD Geriatric Education Center Michigan State UniversityLearning ObjectivesWhat is Normal?NORMAL AGINGNo consistent, progressive deviations on testing of memorySome decline in processing and recall of new information: slower, harderReminders work – visual tips, notesAbsence of significant effects on ADLs or IADLs due to cognitionSlide What is MCI?(Mild Cognitive Impairment)What is Dementia?Dementia is SneakyDaily Activities: IADLs Instrumental Activities of Daily Living** relevant to the medical office visit‘Ten Warning Signs’ Memory loss Difficulty performing familiar tasks Problems with language Disorientation to time and place Poor or decreased judgment Problems with abstract thinking Misplacing things Changes in mood or behavior Changes in personality Loss of initiativeAlzheimer’s Association Brief Screens: Cognitive Function Conversation Clock Drawing Test Mini-Cog Three-Item Recall Clock DrawingJAGS 1993; 41: 576.Clock-Drawing: 4-Point Scoring1 pt - Draws a closed circle1 pt - Numbers in correct positions1 pt - All 12 correct numbers included1 pt - Hands placed in correct positionMini-Cog Negative Screen for Dementia Score of 3 on 3-item recall Normal Clock and a Score of 1 or 2 Positive Screen for Dementia Score of 0 on 3-item recall Abnormal Clock and a Score of 1 or 2Follow-Up EvaluationMini-Mental State Examination (MMSE)Montreal Cognitive Assessment (MoCA)Functional Activities Questionnaire- Bills Checks - Prepare Meal