The neuropsychiatric examination of the young-onset dementias

Simon Ducharme; Bradford C Dickerson

doi:10.1016/j.psc.2015.01.002

The neuropsychiatric examination of the young-onset dementias

Psychiatr Clin North Am. 2015 Jun;38(2):249-64. doi: 10.1016/j.psc.2015.01.002. Epub 2015 Mar 12.

Authors

Simon Ducharme¹, Bradford C Dickerson²

Affiliations

¹ Department of Psychiatry, McGill University Health Centre and Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada. Electronic address: [email protected].
² MGH FTD Unit, Massachusetts General Hospital, 149 13th Street, Suite 2691, Charlestown, MA 02129, USA; Department of Neurology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.

PMID: 25998114
DOI: 10.1016/j.psc.2015.01.002

Abstract

Young-onset dementias frequently present with prominent behavioral features and constitute a diagnostic challenge. Most cases are secondary to neurodegenerative conditions, including the behavioral variant of frontotemporal dementia, which has overlapping symptoms with many primary psychiatric disorders. This article reviews the differential diagnosis and neuropsychiatric assessment of young-onset dementia, which includes detailed history taking, family history, mental status examination, office-based cognitive tests, and a focused neurologic examination. The clinical examination serves to establish the presence of a dementia and the specific clinical syndrome. Biomarkers can be subsequently integrated in a probabilistic model to determine the most likely neuropathological process.

Keywords: Alzheimer disease; Biomarkers; Differential diagnosis; Early onset dementia; Frontotemporal dementia; Neuropsychiatry; Young-onset dementia.

Publication types

Review

MeSH terms

Age of Onset
Alzheimer Disease* / diagnosis
Alzheimer Disease* / psychology
Behavioral Symptoms / diagnosis
Dementia* / diagnosis
Dementia* / etiology
Dementia* / psychology
Diagnosis, Differential
Diagnostic and Statistical Manual of Mental Disorders
Humans
Intelligence Tests
Mental Competency*
Middle Aged
Neuroimaging / methods
Neuropsychological Tests*