Today, PGY-2 and RACE track star Alex Cours presented a case of a 66 year old woman with concerns for memory impairment. We took a thorough history, finding out she had a history of depression on two antidepressants, extensive supplement use, and regular marijuana use. We reviewed a diagnostic schema for memory impairment, discussed various screening tools for dementia, and diagnostic work-up and definition of dementia.
Clinical pearls:
- Not all memory impairment means dementia, or even mild cognitive impairment! Keep a wide differential to consider organic causes of memory impairment. Remember the three “D”s: delirium, dementia, and depression.
- Screening tools such as the mini-cog and MOCA may be positive when abnormal but are NOT diagnostic of dementia
- Screening should only be considered in those with “red flags” or concerns expressed either by individual or family