The problems also have to be substantial enough to affect how the person manages usual life, such as work and family responsibilities. It’s not enough for a person to have an abnormal result on an office-based cognitive test. The problems are bad enough to impair daily life function.
These problems should represent a change, compared to the person’s usual abilities as an adult. These can’t be lifelong problems with reading or math or even social graces. The difficulties are a decline from the person’s prior level of ability.Although it’s common for memory to be affected, other parts of thinking function can be impaired. The 2013 DSM-5 manual lists these six types of cognitive function to consider: learning and memory, language, executive function, complex attention, perceptual-motor function, social cognition. A person is having difficulty with one or more types of mental function.(Although like many aspects of geriatrics, it’s challenging to fit this into a 15 minute visit.)ĭoes this older person have dementia, such as Alzheimer’s disease? To understand how I go about answering the question, let’s start by reviewing the basics of what it means to have dementia.Ī person having dementia means that all five of the following statements are true: It is adapted to real-world constraints, meaning it can be used in a primary care setting. Instead, in this post I’ll be describing the pragmatic approach that I use in my clinical practice. This is especially useful for unusual cases, such as cognitive problems in people who are relatively young. Those clinics have extra time and staff, and are designed to provide an extra-detailed evaluation. Now, note that this post is not about the comprehensive approach used in multi-disciplinary memory clinics. So in this post I want to share what I often find myself explaining to families: the basics of clinical dementia diagnosis, what kind of information I’ll need to obtain, and how long the process can take. However, it’s not very likely that I - or any clinician - will be able to definitely diagnose dementia based a single in-person visit.īut I get this kind of request fairly frequently. This is a reasonable concern to have, given the circumstances. Specifically, he wanted to know if his father has dementia, such as Alzheimer’s disease. The son wanted to know if I could make a housecall. Since then the father had sold his long-time home rather quickly, and was hardly returning his son’s calls.
He explained that his 86 year-old father, who lived in the Bay Area, had recently been widowed. They’re super excited and played a huge part in why we’re here.“Doctor, do you diagnose dementia? Because I need someone who can diagnose dementia.”Ī man asked me this question recently. “They’ve been in the league for a long time, and they haven’t been in this situation before. “Everyone is obviously very hungry to go all of the way,” said Hedman, part of Tampa Bay’s loss to the Chicago Blackhawks in the Stanley Cup Final five years ago. The others are Zach Bogosian, the 12-year veteran who became available in February when Buffalo terminated his contract, and Luke Schenn.
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Shattenkirk, a free agency addition last offseason who is a plus-11 this postseason, and McDonagh are among four Lightning defensemen with at least 10 seasons of NHL experience now in their first Stanley Cup Final. Their other defensemen who have played 20 games this postseason - Heiskanen, Klingberg, 2014 first-rounder Jamie Oleksiak and Esa Lindell - were all drafted by the Stars. The Stars signed 14-year veteran Andrej Sekera as a free agent last summer, and he is finally in his first Stanley Cup Final with his fifth team.
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