Abstract
This chapter emphasizes the value of preliminary observations in making a provisional diagnosis of dementia. Significant aspects of the history are detailed, such as head injury or brain hemorrhage that could lead to hydrocephalus or superficial siderosis. Diagnostic clues are given that facilitate identification of the posterior cortical variant of Alzheimer’s disease, characterized by progressive decline in visuospatial, visuoperceptual, literacy, and praxic skills. Emphasized is the importance of temporal pattern of disease, manifesting as episodic confusion and dementia progressing over a period of months. Further clues are outlined to facilitate identification of frontotemporal dementia variants, including semantic dementia, the behavioral variant, progressive nonfluent aphasia, and logopenic aphasia. The value of physical examination is stressed as it may disclose an underlying structural lesion.
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