Workgroup 1: Dementia

Cognition

Examples of cognitive abilities are learning and memory, attention (divided attention, selective attention), language (ability to speak, writing skills, reading skills, language comprehension), praxis (ability to do deliberate actions or certain compound movements), perception, executive functioning (cognitive flexibility, planning, organisation) and social cognition (empathy).

Neurocognitive disorder (DSM V)

A major cognitive disorder consists of the following things:

• Evidence of substantial cognitive decline in one or more of the cognitive domains
  • Learning and memory
  • Attention
  • Language
  • Perception
  • Praxis
  • Executive functioning
  • Social cognition
• The cognitive deficits are sufficient to interfere with independence in daily life
• Not due to delirium
• Not due to other mental disorders

A mild neurocognitive disorder consists of the following things:

• Evidence of modest cognitive decline in one or more cognitive domains
• The cognitive deficits are insufficient to interfere with independence in daily life
• Not due to delirium
• Not due to other mental disorders

Alzheimer’s disease

To get the diagnosis of Alzheimer’s disease the patient must have a clear decline in memory + a decline in at least one other cognitive domain. Alzheimer’s is very progressive and has a gradual start, in which decline is cognition is noticeable. There is evidence of a causative AD genetic mutation from family history and genetic testing. However, there is no evidence of mixed etiology.

Dementia in the Netherlands is more and more common. Researchers expect the number of people with Alzheimer’s disease to grow, due to people getting older nowadays.

Screening

Dementia screening is done by doing (hetero)anamnesis, tests and questionnaires and observation.

When a (hetero)anamnesis is done, first a reason for attending is given. This is usually done by family members or partners. Specific cognitive problems are checked, like memory, concentration/attention, praxis, language, gnosis and executive functions. A neuropsychologist also ask about functioning in emotion, behaviour and personality, education/profession, the home situation/family (does this person live with anyone else?) and medical history (has the patient taken any medication?).