Dementia: Types

Key points

• Alzheimer's (~60%): insidious memory impairment, hippocampal/medial temporal atrophy; NICE acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) for mild-moderate; memantine for moderate-severe.
• Vascular dementia (~20%): stepwise deterioration, focal signs, risk factors.
• Lewy body dementia: fluctuating cognition · visual hallucinations · parkinsonism; EXTREME sensitivity to antipsychotics (avoid).
• Frontotemporal dementia (Pick's): early personality/behaviour change or language impairment.
• Reversible causes to screen: B12, TFTs, syphilis serology, CT if atypical.