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This chapter provides an overview of the three most common disorders likely to be encountered by geriatric providers. Together, tremors, parkinsonism, and gait disorders are common enough that nearly one in three patients in a geriatrics clinic may be affected by at least one of these disorders. Each section begins with definitions of each of the conditions, clinical phenomenology, and features, followed by practical treatment approaches and algorithms. In addition, when there is overlap between conditions (i.e., atypical parkinsonism), hallmarks and red flags of each condition will be highlighted to help to compare and contrast.
The most common movement disorders encountered in the geriatric patient population are Parkinson’s disease and related forms of parkinsonism, followed by tremors, gait disorders, and ataxia. Key clinical features allow the clinician to make the appropriate diagnosis and to develop the subsequent treatment plan to manage the disorder.
The longitudinal assessment of episodic and semantic memory was obtained from 236 patients diagnosed with Alzheimer’s disease (AD, n = 128) and with frontotemporal lobar degeneration (FTLD, n = 108), including patients with a social comportment/dysexecutive (SOC/EXEC) disorder, progressive nonfluent aphasia (PNFA), semantic dementia (SemD), and corticobasal syndrome (CBS). At the initial assessment, AD patients obtained a lower score on the delayed free recall test than other patients. Longitudinal analyses for delayed free recall found converging performance, with all patients reaching the same level of impairment as AD patients. On the initial evaluation for delayed recognition, AD patients also obtained lower scores than other groups. Longitudinal analyses for delayed recognition test performance found that AD patients consistently produced lower scores than other groups and no convergence between AD and other dementia groups was seen. For semantic memory, there were no initial between-group differences. However, longitudinal analyses for semantic memory revealed group differences over illness duration, with worse performance for SemD versus AD, PNFA, SOC/EXEC, and CBS patients. These data suggest the presence of specific longitudinal patterns of impairment for episodic and semantic memory in AD and FTLD patients suggesting that all forms of dementia do not necessarily converge into a single phenotype. (JINS, 2010, 16, 278–286.)
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