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Recognizing Dementia can be Tricky

Kelly J. Murphy, PhD, C.Psych., Neuropsychologist, Neuropsychology & Cognitive Health, Baycrest; Assistant Professor, Psychology, University of Toronto.
Angela K. Troyer, PhD, C.Psych, Professional Practice, Chief of Psychology, Baycrest, Assistant Professor, Psychology, University of Toronto.

Abstract
Dementia is characterized by multiple cognitive impairments that cause significant functional decline. Based on this brief definition, the initial expectation might be that recognizing dementia in a patient is straightforward. Not true. Recognizing dementia can be tricky, particularly in patients who present as alert, socially appropriate, and capable of providing reasonable answers to questions. We briefly outline signs on casual observation that would prompt investigation into a patient's current cognitive and functional status to determine the presence of dementia during a routine visit. Approaches to screening for cognitive and functional decline are described along with first-step recommendations to connect patients and families with resources. The front-line clinician plays a pivotal role in identifying dementia with earlier intervention having the most potential to offset the burden on patients, families, and society.
Keywords: dementia, activities of daily living, functional decline, cognitive decline.