Differential diagnosis The implementation and application of existing collaborative care models, such as DICE, can aid in avoiding misdiagnosis. Comorbidities (such as vascular, infectious, traumatic, autoimmune, idiopathic, or even becoming malnourished) have the potential to mimic symptoms of dementia. For instance, studies have also shown a relationship between depression and its cognitive effects on everyday functioning and distortions of memory. Investigations such as PET and SPECT imaging of the brain show reduced blood flow in areas of the brain in people with Alzheimer's disease (AD) compared with a more normal blood flow in those with<unk> , and the MRI shows medial temporal lobe atrophy in people with AD.<unk>  vs. dementia<unk>  symptoms can appear similar to dementia. Due to the similar side effects to dementia, this can result in a misdiagnosis of depression, or the adverse effects of medications being taken. This form of dementia is not the original form and does not result from the same cognitive changes. Once the depression is properly treated or the medication therapy is changed, the cognitive impairment can be effectively reversed. Generally, dementia involves a steady and irreversible cognitive decline but in some cases there may be different outcomes. In addition, diminished mental capacity and social withdrawal are commonly identified as symptoms in the elderly but oftentimes is due to symptoms of depression. As a result, elderly patients are often misdiagnosed especially when healthcare professionals do not make an accurate assessment. Older people with predominantly cognitive symptoms such as loss of memory, and vagueness, as well as prominent slowing of movement and reduced or slowed speech, were sometimes misdiagnosed as having dementia when further investigation showed they were suffering from a major depressive episode. This was an important distinction as the former was untreatable and progressive and the latter treatable with antidepressant therapy, electroconvulsive therapy, or both. In contrast to major depression, dementia is a progressive neurodegenerative syndrome involving a pervasive impairment of higher cortical functions resulting from widespread brain pathology. A significant overlap in cognitive and neuropsychological dysfunction in Dementia and<unk>  patients increases the difficulty in diagnosis. Differences in the severity of impairment and quality of patients' responses can be observed, and a test of antisaccadic movements may be used to differentiate the two, as<unk>  patients have poorer performance on this test. Individuals with<unk>  present considerable cognitive deficits, including disorders in learning, memory and psychomotor performance. Substantial evidences from brain imaging such as CT scanning and positron emission tomography (PET) have also revealed abnormalities in brain structure and function. A comparison between dementia and<unk>  is shown below. Variable<unk>  Dementia Onset More precise, usually in terms of days or weeks Subtle Course Rapid, uneven Slow, worse at night Past history Depression or mania frequently Uncertain relation Family history Depression or mania Positive family history for dementia in approximately 50% DAT Mood Depressed; little or no response to sad or funny situations; behavior and affect inconsistent with degree of cognitive deficit Shallow or labile; normal or exaggerated response to sad or funny situations; consistent with degree of cognitive impairment Cooperation Poor; little effort to perform well; responds often with "I don't know"; apathetic, emphasizes failure Good; frustrated by inability to do well; response to queries approximate con fabricated or perseverated; emphasizes trivial accomplishment Memory Highlight memory loss; greater impairment of personality features (e.g. confidence, drive, interests, and attention) Denies or minimizes impairments; greater impairment in cognitive features (recent memory and orientation to time and date) Mini-Mental State Exam (MMSE). Changeable on repeated tests Stable on repeated tests Symptoms Increased psychologic symptoms: sadness, anxiety, somatic symptoms Increased neurologic symptoms: dysphasia, dyspraxia, agnosia, incontinence Computed Tomography (CT) and Electroencephalogram (EEG) Normal for age Abnormal
Pseudodementia
Procidentia
Subcortical dementia
Semantic dementia
Dementia
Vascular dementia
Early-onset Alzheimer's disease
Alcohol-related dementia