Confusion/Memory Loss

Alzheimer’s Disease

Creutzfeldt-Jakob Disease (CJD)

– Dementia, mood, anxiety, movement disorders
– Rapidly progressive dementia; usually sporadic but can be rarely familial. Occurs in 7th decade, fatal in 7 months.
– Caused by prions (small proteinaceous particle’s that cause spongiform changes in the brain)


1. Disturbance of CONSCIOUSNESS (can’t focus or shift attention)
2. Change in COGNITION (memory, language)
3. Develops over SHORT period of time and FLUCTUATES
4. Caused by a general MEDICAL condition

Depression with Pseudodementia

– Patient often tends to emphasize disability related to memory loss much more than patients experiencing true dementia
– Appears to have dementia
– Unable to remember correctly,
– Cannot calculate well
– Complains, bitterly, of lost cognitive abilities or skills
– High risk of progressing to dementia
– Depression or mild depressive symptoms can be comorbid

– Recent weight loss
– Worsening sleep
– Frequent crying spells
– Self-deprecating comments,
– Recent-onset behavior changes (social withdrawal, psychomotor agitation, extreme negativism)


Hypoglycemia Mnemonic
T – Tachycardia
I – Irritability
R – Restless
E – Excessive Hunger
D – Diaphoresis/Depression

Hypoglycemia Symptoms
– Autonomic: Anxiety, Palpitations, Sweating, Tingling, Trembling
– Neuroglycopenia: Irritability, drowsiness, dizziness, blurred vision, difficulty with speech, confusion, feeling faint

Normal Pressure Hydrocephalus (NPH)

– Adams/Hakim Triad (“wet, wobbly and wacky”):
1. Wet = Incontinence
2. Wobbly = Gait ataxia (Wide-based)
3. Wacky = Dementia

Vascular (multi-infarct) dementia

– Often coexists with Alzheimer’s Disease
– Look at history of atherosclerotic vascular disease (i.e. stroke, MI)
– Classically more step-wise deterioration in vascular dementia compared to steady cognitive decline seen in Alzheimer
– May be earlier loss of executive function and personality changes in vascular dementia