Risk Factors and Diagnosis

Risk factors for dementia include a family history of dementia, head trauma,
lower educational level, and gender (women are more prone than men to
dementia). Alcohol and drug abuse, infections, cardiovascular disease, and
head injuries are also causes for the development of dementia.

The criteria in the American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders: DSM-IV-TR (rev. 4th ed., 2000) for the diagnosis
of dementia require the presence of multiple cognitive deficits in addition
to memory impairment. The diagnosis of dementia is based on
cognitive deficits that are severe enough to cause impairment in occupational
or social functioning and must represent a decline from a previous
level of functioning. The nature and degree of impairment are variable and
often depend on the particular social setting of the individual. Standardized
mental status tests are a baseline for evaluation for dementia. Examples of some short tests are the Mini-Mental Status Test, the Blessed Information-
Memory-Concentration Test, and the Short Portable Mental Status Questionnaire.
A standardized mental status test score should be used to confirm
the results of a history and physical examination. Standardized mental status
tests should not be the single deciding factor for the diagnosis of dementia.
Some tests such as blood evaluations, urinalysis, chest radiography,
carotid ultrasound, Doppler flow studies, electroencephalogram, lumbar
puncture, and computed tomography (CT) scans of the head are done in
relation to the presenting symptoms.