Young Onset Dementia- Initial Assessment

Presenting Problems 1 2 3 4 5 6 7 8 9 Vascular Risk factors 1 2 3 4 5 6 7 8 9 10 11 12 Diabetes Mellitus Hypertension Hypercholesterolemia Smoking h/o TIA h/o CVA Peripheral vascular Disease Atrial Fibrillation Valvular Heart Disease Memory related Language related Behavioural problems Neurological Disorder Basic ADLs Instrumental ADLs

Moderate. previous cognitive assessment. medico legal /claims outstanding Others OTHER MEDICAL DISORDERS Disorder Duration MEDICATIONS MEDICATION 1 2 3 4 DOSE . current support network. Severe – When? H/o hospitalisation.Neurological Problems Parkinson’s disease Huntington’s disease Multiple Sclerosis Motor Neuron Disease Progressive Supra Nuclear Palsy CVA Restless Leg Syndrome Heavy metal Exposure Hazardous occupation Traumatic Brain Injury – Mild.

history +MSE Others .history +MSE . 4. peptic ulcer disease .freq falls Psychological complications Inability to control Period of abstinence if any Psychiatric History Psychosis Depression Anxiety Disorder Bipolar Disorder Alcohol/drug misuse Personality Disorder Others Treatment received /receiving for any of the above Current Psychiatric problems 1. HADS.peripheral neuropathy.5 6 7 8 9 10 11 12 Alcohol History How many years Typical drinking pattern Binging or continuous drinking Average drinks per day No of Units per week Worst day Withdrawal features Tolerance Physical complications – cirrhosis. jaundice. history +MSE Psychosis – BPRS. 2. history +MSE Anxiety Disorder – HADS. Depression – BDI. 3.

patient is very dependent. getting in or out of the tub or shower. (0 POINTS) Needs help transferring to the toilet. (0 POINTS) Is partially or totally incontinent of bowel or bladder (0 POINTS) Needs partial or total help with feeding or requires parenteral feeding. Score of 0 = Low. cleans genital area without help. gets on and off. . (1 POINT) Gets food from plate into mouth without help. arranges clothes. Dependence (0 Points) WITH supervision. BATHING Points: __________ DRESSING Points: __________ TOILETING Points: __________ TRANSFERRING Points: __________ CONTINENCE Points: __________ FEEDING Points: __________ Total Points: ________ Score of 6 = High. (1 POINT) Goes to toilet. direction. Mechanical transfer aids are acceptable (1 POINT) Exercises complete self control over urination and defecation. Patient is independent. (0 POINTS)Needs help in moving from bed to chair or requires a complete transfer. Requires total bathing (0 POINTS) Needs help with dressing self or needs to be completely dressed. (1 POINT) Moves in and out of bed or chair unassisted. personal assistance or total care (0 POINTS) Need help with bathing more than one part of the body. May have help tying shoes. direction or personal assistance (1 POINT) Bathes self completely or needs help in bathing only a single part of the body such as the back.Katz Index of Independence in Activities of Daily Living Activities Points (1 or 0) Independence (1 Point) NO supervision. genital area or disabled extremity (1 POINT) Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. cleaning self or uses bedpan or commode. Preparation of food may be done by another person.

) .A.D.L.INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE (I.

and to depression "D". occasionally Not at all 3 2 1 0 I get a sort of frightened feeling A as if something awful is about to happen: Very definitely and quite badly 3 Yes. They should give an immediate response and be dissuaded from thinking too long about their answers. The questions relating to anxiety are marked "A". The score for each answer is given in the right column.Hospital Anxiety and Depression Scale (HADS) Patients are asked to choose one response from the four given for each interview. but it doesn't worry me Not at all I can laugh and see the funny D side of things: As much as I always could Not quite so much now Definitely not so much now Not at all Worrying thoughts go through A my mind: A great deal of the time A lot of the time From time to time. A I feel tense or 'wound up': Most of the time A lot of the time From time to time. but not too badly A little. but not too often Only occasionally D I feel cheerful: Not at all Not often Sometimes Most of the time 2 1 0 0 1 2 3 3 2 1 0 3 2 1 0 . Instruct the patient to answer how it currently describes their feelings.

A I can sit at ease and feel relaxed: Definitely Usually Not Often 0 1 2 3 3 2 1 0 Not at all D I feel as if I am slowed down: Nearly all the time Very often Sometimes Not at all A I get a sort of frightened feeling like 'butterflies' in the stomach: Not at all Occasionally Quite Often Very Often D I have lost interest in my appearance: Definitely I don't take as much care as I should I take just as much care as ever A I feel restless as I have to be on the move: Very much indeed Quite a lot Not very much Not at all D I look forward with enjoyment to things: As much as I ever did Rather less than I used to Definitely less than I used to Hardly at all 0 1 2 3 3 2 0 I may not take quite as much care 1 3 2 1 0 0 1 2 3 .

The norms below will give you an idea of the level of Anxiety and Depression. Add the Ds = Depression). 0-7 = Normal 8-10 = Borderline abnormal 11-21 = Abnormal Reference: Zigmond and Snaith (1983) .A I get sudden feelings of panic: Very often indeed Quite often Not very often Not at all 3 2 1 0 D I can enjoy a good book or radio or TV program: Often Sometimes Not often Very seldom 0 1 2 3 Scoring (add the As = Anxiety.