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The Mental Status Examination in Patients With Suspected Dementia

Grossman, Murray MD, FAAN; Irwin, David J. MD

CONTINUUM: Lifelong Learning in Neurology: April 2016 - Volume 22 - Issue 2, Dementia - p 385–403
doi: 10.1212/CON.0000000000000298
Review Articles

ABSTRACT Purpose of Review: This article describes a comprehensive approach to the mental status examination and diagnostic workup of patients suspected of having an emerging neurodegenerative dementia. Key strategies for obtaining a history and bedside examination techniques are highlighted.

Recent Findings: Classic descriptions of behavioral neurology syndromes were largely based on clinicopathologic correlations of strategic lesions in stroke patients. While still very important, advances in neuroimaging have expanded our armamentarium of cognitive evaluations to include assessments of findings in nonstroke anatomic distributions of disease. These efforts support comprehensive assessments of large-scale cerebral networks in cognitive neurology.

Summary: A thorough and focused mental status examination is essential for the evaluation of patients with cognitive symptoms. Selective use of laboratory testing and neuroimaging can aid in the diagnosis of dementia by excluding non-neurodegenerative etiologies. Neurodegenerative disease–specific tests are in development and will enhance diagnosis and efforts for disease-modifying therapy development.

Address correspondence to Dr Murray Grossman, Department of Neurology, 2 Gibson, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104-4283,

Relationship Disclosure: Dr Grossman receives personal compensation for serving as a consultant for C2N Diagnostics, as a lecturer for the Lundbeck Institute, for serving on the international scientific advisory board of the Max Planck Institutes, and for serving as associate editor of Neurology. Dr Grossman’s institution has received grant support from the National Institutes of Health (AG017586, AG038490, NS044266, and NS053488), and Dr Grossman has received research support from the Arkin Family Foundation, the Samuel I. Newhouse Foundation, Inc, and the Wyncote Foundation. Dr Irwin’s institution receives grant support from the National Institutes of Health and the National Institute of Neurological Disorders and Stroke (K23NS088341-01).

Unlabeled Use of Products/Investigational Use Disclosure: Drs Grossman and Irwin report no disclosures.

© 2016 American Academy of Neurology
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