Walden University
NURS6521- Advanced Pharmacology
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, Decision Tree for Neurological and Musculoskeletal Disorders
Dementia affects more than 5 million adults and has a significant cost in health
conditions, and it is the fifth leading cause of death among Americans 65 years and older. The
prevalence of dementia among 65 years and older is expected to double by 2060. Risk factors for
dementia include age; family history of dementia; personal history of cardiovascular disease,
cerebrovascular disease, diabetes mellitus, or midlife obesity; use of anticholinergic medications;
apolipoprotein E4 genotype; and lower education level (Falk et al., 2018). Family members
usually notice changes in the behavior of their loved ones, which prompt them to seek medical
treatment. If dementia is suspected, there are multiple screening tools that can be used. One of
them is the Mini-Mental State Examination (MMSE). It is a brief, quantitative measure of
cognitive status in adults. It can be used to screen for cognitive impairment, estimate the severity
of cognitive impairment at a given point in time, follow the course of cognitive changes in an
individual over time, and document an individual's response to treatment. It is the most
commonly used cognitive and evaluation tool due to its sensitivity of 89% and specificity of 81%
in detecting dementia (www.parinc.com). When cognitive impairment is established, diagnostic
testing and secondary evaluation, including screening for depression, appropriate laboratory
studies, magnetic resonance imaging of the brain, and genetic testing, should be performed (Falk
et al., 2018).
Alzheimer's disease (AD) is characterized by progressive memory loss, impaired
thinking, neuropsychiatric symptoms such as hallucinations and delusion, and the inability to
perform activities of daily living, it is a devastating illness that affects more than 5.5 million
Americans. The exact underlying cause of AD is still unknown. Scientists believed that it is a
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