1. Dementia  Problem:  Economical  Social  Medical  Late diagnosis  Insufficient prevention of VaD

2. Perspectives of age distribution in population Source: United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects. The 2004 Revision. New York : United Nations, 2005.

3. Prevalence of dementia Canadian Study of Health and Aging: study methods and prevalence of dementia. CMAJ 1994;150:899–913.

5. The most frequent dementias

6. Diagnosis  Dementia - Gradual and progressive change in memory function at disease onset reported by patients or relatives for a period greater than 6 months  + 1 next sign - - aphasia - apraxia - agnosia

7. Diagnosis  History ( from patient + from relatives)  MiniMental State Examination - MMSE  Clock test  Activities of daily living- phoning, transportation, using of drugs, shopping, etc. )

8. MMSE zOrientation 1. Year 2. Season 3. Month 4. Date 5. Day zOrientation 6. Country 7. County 8. City 9. Name of the institution 10. Floor 1 point for each answer

9. MMSE Memory 11. Reproduction of 3 terms (0-3) (apple, table, tree) Attention and counting 12. Counting 100 –7,.... or (terms) (0-5) 13. Reproduction of 3 terms from 11. (0-3)

10. MMSE Higher cognitive functions 14. Clock (0-1) 15. Pencil (0-1) 16. Repeating (0-1) 17. Understanding (3-steps) (0-3) 18. Understanding (1-step) – CLOSE THE EYES (0-1) 19. Writing the sentence(0-1) 20. Picture (0-1)

11. MMSE

12. Summary 25 - 30 normal (24-25 mild cognitive impairment) 20 - 24 mild dementia 10 - 19 moderate dementia 0 - 9 severe dementia

13. Clock test

14. 1 point - the clock circle 1 point - for all the numbers being in the correct order 1 point - for the numbers being in the proper special order 1 point - for the two hands of the clock 1 point - for the correct time. A normal score is 4 or 5 points.

15. Clock test

17. Others – 5% - most of them we can treat zHypothyreosis zAnemia zNeuroinfections (neuroboreliosis, neurpsyphylis, HIV, CJD,...) zMetabolic, toxic etiology zBrain tumors zAutoimunne limbic encephalitis zNormotension hydrocephalus zHypovitaminosis B12 zChronic alcoholism zHead injury