Medical history (history of illness) represents an important component in the diagnosis of “mild cognitive impairment.” Family history
- What is the general health status of your relatives?
- Are there any diseases in your family that are common?
- Are there any hereditary diseases in your family?
Social history
- What is your profession?
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current anamnesis/systemic anamnesis (somatic and psychological complaints) [self or external anamnesis].
- How long have these changes existed?
- Did the limitations start acutely or did it develop slowly?
- How are aging activities affected?
- Mild aging activities?
- Complex aging activities (e.g., arranging finances)?
- To what extent are activities of daily living impaired?
- Who perceives the impairment of daily activities?
Vegetative anamnesis including nutritional anamnesis.
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol more often? If yes, what drink(s) and how many glasses of it per day?
- Do you use drugs? If yes, which drugs and how often per day or per week?
Self history incl. medication history.
- Pre-existing conditions (cardiovascular disease; neurological disease).
- Operations
- Radiotherapy
- Vaccination status
- Allergies
- Environmental history
- Medication history
Medication history
- ACE inhibitors
- Antiarrhythmics
- Antibiotics
- SS-lactam antibiotics
- Fluoroquinolones
- Penicillin in high doses
- Alpha blockers
- Anticholinergics
- Antidepressants
- Serotonin–norepinephrine reuptake inhibitors (SSNRIs).
- Serotonin reuptake inhibitor (SSRI).
- Tricyclic antidepressants
- Antidiabetic agents, oral – which induce hypoglycemia.
- Antiepileptic drugs, including phenytoin.
- Antihypertensives
- Seniors still taking antihypertensives at age >85 years were more likely to have cognitive impairment and increased mortality risk; low systolic blood pressure was also associated with accelerated cognitive decline.
- Anticonvulsants
- Antivertiginosa
- Benzodiazepines
- Beta blockers
- Calcium antagonists
- Digoxin
- Diuretics
- Glucocorticoids
- MAO inhibitors
- Neuroleptics (D2 antagonists and serotonin–dopamine antagonists).
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
- Nitrates and other vasodilators.
- Lidocaine
- Opiates/opioid analgesics
- Parkinson’s disease medications, e.g., bromocryptine, amantadine
- Psychotropic drugs
- Sedatives; these include diazepam in particular.
- Sedating H1 antihistamines
- Statins (statins (simvastatin, atorvastatin; both agents are lipophilic and cross the blood–brain barrier): In one study, physicians had reported various memory disturbances (ranging from isolated memory lapses to retrograde amnesia) in 3.03% of statin users during the course of therapy. These disturbances also occurred in 2.31% of statin nonusers. The adjusted odds ratio was 1.23, which was significant at a 95% confidence interval of 1.18 to 1.28. This indicates a slight increase in memory disorders. The association was more marked in the first 30 days of therapy (0.08% of statin users versus 0.02% of nonusers).
- Theophylline
Note
- After taking the history, a neuropsychological test (e.g., Mini Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA)) should be administered, if appropriate.Note: MoCA has been shown to be more sensitive in detecting mild cognitive deficits than the MMSE. The interview-style test takes approximately 10 to 15 minutes to complete.
