Some factors that may ...

Some of the factors that may affect the results of neuropsychological testing • Very high or very low levels of education · Visual impairment, hearing impairment, sensory disorders · Poor motivation patient · Tired patient · emotional-personal invasion of Psychotic disorders · Side effects of medicines . Adverse effects on cognition may have and medications that are assigned to persons of elderly for various reasons. Side effects of drug therapy in elderly patients found significantly more often than patients of younger age. This is due to several reasons: the typical contingent of elderly patients with polypharmacy, false designation of certain drugs, drug interactions, altered pharmacokinetics, increased sensitivity to drugs. Medications that may cause cognitive impairment · Sedatives and hypnotics (benzodiazepine derivatives, barbiturates) · Analgesics · Psychotropic drugs · Cardiac drugs (cardiac glycosides, amiodarone, antihypertensives, b-blockers) · Antineoplastic · Anticonvulsants · anticholinergics · antiparkinsonian drugs · Corticosteroids. Evaluation of medical history data and neurological examination, including assessment of cognitive, as well as instrumental and laboratory studies provide important information indicating that the etiology of dementia in this particular patient. In evaluating the medical history should be taken into account the nature of the progression of cognitive defect. For dementia because of acute neurological disease characterized by sudden onset and often the lack of progression in the future. Acute onset of disease occurs in infectious, traumatic and vascular lesions of the central nervous system, metabolic disorders, toxic action of drugs; subacute top characteristic for the bulk of the brain, Creutzfeldt-Jakob disease and normotensive hydrocephalus. In patients with dementia, attention should be paid to the possible presence of focal neurological symptoms (visual field disturbances, hemiparesis, gemigipesteziya, asymmetry of deep reflexes, unilateral extensor plantar reflex, etc.), extrapyramidal disorders and disorders of the foot. Results of neurological examination are often key in diagnosing the underlying disease that led to the development of dementia. Neurological examination of patients with dementia, focal neurological symptoms · Tumors and other space-occupying lesions of the brain · Chronic subdural hematoma · Post-stroke vascular dementia (eg, after a heart attack in a strategically important zone), multifocal neurological symptoms: · Vascular lesions of the brain - multi-infarct dementia · sclerosis · cancerous meningitis · progressive multifocal leukoencephalopathy · Post-traumatic encephalopathy, instrumental and laboratory examination is necessary, first of all, to avoid metabolic and organic (structural) brain lesions.