Brief Answer:
Depression and psychosis - major risk

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Based on clinical history, reports and query, my opinion is as follows:

1. Features you need to watch out for early onset of dementia are :

a. Earliest would be mild confusion, followed by apathy and changes in personality.

b. As time progresses - depression, psychosis and memory gets affected (Impaired ability to learn new information, Impaired ability to recall previously learned information, language disturbance, Inability to carry out motor activities despite intact motor function.)

As the situation worsens, other symptoms are:

e. Failure to recognize or identify objects with normal sensory function or eyes and touch.
f. Unable to plan or organize anything - marked difficulties in judgement and dependence on others for daily activities
g. Euphoria, elation, depression or aggressive behaviors become common as disease progresses.


2. History of stroke, would suggest a possible vascular dementia as the cause. CT scan is showing typical features of stroke induced changes.

3. Vascular dementia would be abrupt in onset, with a fluctuating course. Personality might be well preserved. He might show depression and features of psychosis.

4. At present medication, or infection might be clouding the consciousness. Evaluation should be done after complete treatment of the present multiple disorders.

5. Hiatus hernia or stomach in mediastinal cavity needs to be treated, if any serious symptoms are present. Gastritis or esophageal reflux would be common and can be treated with proton pump inhibitors. Surgery is not necessary, if he does not have any serious symptoms.

Hope it helps.

Any further queries, happy to help again.

Take Care.

Dr. Prakash HM

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