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Assessment and diagnosis of the non-Alzheimer dementias 

Assessment and diagnosis of the non-Alzheimer dementias
Chapter:
Assessment and diagnosis of the non-Alzheimer dementias
Author(s):

Chiadi U. Onyike

DOI:
10.1093/med/9780198701590.003.0127
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date: 23 August 2019

Non-Alzheimer dementias are commonly distinguished from Alzheimer disease by younger age at onset (midlife or earlier), positive family history, and presentations characterized by non-amnesic cognitive deficits, psychiatric states (such as depression, compulsions, paranoia, and hallucinations) and motor dysfunctions (like parkinsonism, ataxia, and apraxia). Missed diagnosis is a common problem, with the conditions being mistaken for psychiatric or movement disorder. Timely diagnosis depends on methodical examinations that characterize the chronology and tempo of key symptoms, family history, and neurological features, and brain images that reveal telltale patterns of atrophy or dysfunction. Genetic, blood, and CSF assays, and EEG are indicated where family history is positive or illness progression rapid. As non-Alzheimer dementias pose many clinical and psychosocial problems, optimal care requires a multidisciplinary team, empowered carers, and leverage of community resources. The latest discoveries in neuroimaging, particularly amyloid-PET, tau-PET, and clinical genetics, promise improvements in diagnostics and new therapeutic opportunities.

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