Interview

• Input from family (collateral)
• Functional impairment* (Hallmark for MPI vs Dementia)
• Safety
• Time course
  • < 12 mon: rapidly progressing

  • 12 mon: gradual

  • Note the evolution of symptom (initial → toward the end)
    • Initial symptom is very important
• Medications
  • Polypharmacy
• PMHx
  • Vascular risk factor
• Other symptoms
  • Mood/Personality changes
  • Behavioural changes
  • Dietary changes
  • Hallucinations
  • Language
  • Visuospatial/perceptual
  • Executive function/organization
• Questions
  • You mentioned that you had been having difficulties with your memory. Can you give me some specific examples?
  • What is today’s date?
  • What did you have for dinner last night?
  • Do you have difficulty with your concentration, such as following a conversation or the plot of a movie or TV show?
  • Did you ever get lost in your neighbourhood or places that you are familiar with?

Observations

• Are they repetitive?
• Are they turning to their family to answer questions?
• Do they remember details of the conversation?

Physical Exam (tests)

• MMSE (≥24/30)
• MOCA (≥26/30) → more challenging