Dementia Cause and Assessment

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DementiaCause andAssessment
?????????????? ????????????
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???????????????????????????????

• 1. ???????????????????? ???? ?????????????
  ????????????? ???????
• 2. ??????????????????
• 3. ?????????????????
• 4. ?????????????????? ????
• ??????? ?? 1 ?? 12 ????? ?????

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??????????????????????

• ???????????????????? - degenerative
• ????????????????????
• ?????????????
• ??????????????? Lewy body
• ?????????? 2 ???? (Fronto- temporal dementia)
• ?????????????????????
• ?????????????

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AD
????????

• Symptoms
• cognitive impairment
• aphasia
• visuospatial disorientation

???? Alzheimer
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??????????????????????

• ???????????????? vascular dementia
• ???????????? - ischaemia
• ???????????? - infarct
• ?????????? - single
• ????????? - multiple

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????????????? B1???????????????????????????

• ????????????? B12 ????
• ????????????????????????????????????????????
  (gt 10 ??)
• ?????????????????????????????????????????????????
  ?

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• ?????????? B12
• ??? (Anemia)
• MCV Mean corpuscular volume
• ???????? MCV 85 - 94
• ???????? MCV ??? 60 70
• ??????????????????? (microcytic anemia)
• ??? B12 MCV ??? gt 100
• ????????????????? (megaloblastic anemia

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??????????????????????

• ?????????????????
• ???????
• ????????????
• ???????? - ???????
• ????/?????????????????

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???????????????????????????????

• 5. ????????????????????????????? ????
  ?????????????????????????????????????
  ???????????????????????
• 6. ???????????????? ?????????? ? ( ??????????)
• 7.?????????????? ???????????????????????????
  (Frontal lobe)

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??????????????????????

• ?????????????????????? ???????
• ???????????????????????????/????
• ???????????????????????/????
• ??????
• ?????

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???????????????????????????????

• 8.?????????????????????????????????????? (Normal
  Pressure Hydrocephalus)
• 9.??????????????????? ????????????????????????????
  ??????? (????????? ?????????????
• ???????? )
• 10.????????????????????? (Vasculitis - temporal
  arteritis)

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Normal Pressure Hydrocephalus (NPH)

• ??????????????????????????????????????
  ????? ??????????? (Gait ataxia)
• ?????????????????? (Urinary incontinence)
  ?????????? (Dementia)

???????????????????????????????? degenerative
change ???????????????????????????????????????????
???????????????????
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????????????????????????

• ???????????????????????? (??? / ???)
• ???????????? 12
• ?????????????????? ??????????????????????????
• ???????????????????

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?????????????????

• 1. ??????? cognitive function
  ????????????? domain ?
  ????????????????????????????
• MMSE (TMSE, CMT, MMSE-T)
• clock draw
• 7 minute

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????????

• MMSE
• CMT
• TMSE
• MMSE Thai

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Mini-Mental State Examination-Thai version
(MMSE-T)

• Questions Points
• 1. Orientation (5 ?????)
• ??? /?????? /?????/ ?? / ??? Points 5

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Mini-Mental State Examination-Thai version
(MMSE-T)

• Questions Points
• 2. Registration (5 ?????)
• 2.1 ????????????????? ??????????????
  ?????????????
• ????????? ??????????? ???????
• 2.2 ?????????????????????????????
• ???????????????? ??????? ??? ?????
• ??????? ??? Points 5

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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 3. Registration (3 ?????)
?? (?????) ???????????? 3 ?????
(?????? ????? ????) ???????????????????????
?????????????????????? ????????????????????
?????????? ?????????? Points 3
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 4. Attention/Calaulation
(5 ?????) (??????????????????) 4.1 ?????????
100 ?????????? 7 ???????????????????? ????????????
??? 7 ??? ???????????????????? ?
??? ??????????????????? 4.2 ????????? 20
?????????? 3 ?? 5 ??????????????? 4.3
????????????????????? Points 5
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 5. Recall - ( 3
?????) ?????? 3 ??????????????????? 3
Points 3
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 6. Naming ( 2 ?????)
??????????????????????????????????
??????????????? Points 1
?????????????????????????????????????????
??????????????? Points 1
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 7. Repetition (1 ?????)
????????? ???????????????? Points 1
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 8. Verbal command ( 3
?????) ??????????? (?????)
???????????????????????? ??????????
??????????????????? 2 ???? ?????????????
(???? ???? ?????) Points 3
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 9. Written command ( 1
?????) ????????????????????????????? ??????
?????????????????????????????????
Points 1
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 10. Written ( 1 ?????)
?????? ???????????????????????? 1 ??????
?????????????????????????????
??????????????????????????????????????
??????????????????????????????? Points 1
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Mini-Mental State Examination-Thai version
(MMSE-T)
Questions Points 11. Visuoconstruction ( 1
?????) ?????????????????????????????????????
???????? ??????????????? Points
1 ????????????????????????????????????????
Total Points 30
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?????????????????

• 2. ???????????????????????????????? (Activities
  of Daily Living)
• Instrumental ADL
• Basic ADL
• Global Deterioration Scale (GDS)

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Examples of instrumental and basic ADL

• Instrumental
• ??????????????
• ?????????????
• ???????
• ?????????????
• ?????????????????????????????

• ADL
• ??????????????????
• ?????????????????????
• ???????????
• ??????????????
• ??????????????

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Examples of instrumental and basic ADL

• Basic ADL
• Dressing
• Grooming
• Bathing
• Toileting
• Eating
• Transferring
• Ambulation