Mild Cognitive Impairment: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Trisomy 21 (Down syndrome) – specific human genomic mutation in which the entire 21st chromosome or parts of it are present in triplicate (trisomy). In addition to physical characteristics considered typical for this syndrome, the cognitive abilities of the affected person are usually impaired; furthermore, there is an increased risk of leukemia.

Respiratory system (J00-J99)

  • Chronic obstructive pulmonary disease (COPD)
  • Pulmonary insufficiency – inability of the lungs to provide sufficient oxygen.

Blood, blood-forming organs – immune system (D50-D90).

  • Anemia (anemia)
  • Polycythaemia vera – abnormal proliferation of blood cells (particularly affected are: especially erythrocytes/red blood cells, to a lesser extent also platelets (thrombocytes) and leukocytes/white blood cells); stinging itching after contact with water (aquagenic pruritus).
  • Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic disease of connective tissue with granuloma formation.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Diabetes mellitus (hypo- and hyperglycemia/ hypoglycemia and hyperglycemia).
  • Electrolyte disorders such as.
    • Hyponatremia (sodium deficiency)
    • Hypernatremia (excess sodium)
  • Hyperlipidemia / hyperlipoproteinemia (lipid metabolism disorders).
  • Hyperparathyroidism (parathyroid hyperfunction).
  • Hypopituitarism (hypothyroidism).
  • Hyperthyroidism (hyperthyroidism)
  • Hypoparathyroidism (parathyroid hypofunction).
  • Hypothyroidism (hypothyroidism)
  • Malnutrition (veganism)
  • Addison’s disease (primary adrenal insufficiency) – disease caused by the hypofunction of the adrenal cortex with decreased hormone production.
  • Cushing’s disease – group of diseases leading to hypercortisolism (hypercortisolism; excess of cortisol).
  • Wilson’s disease (copper storage disease) – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed by one or more gene mutations.
  • Porphyria or acute intermittent porphyria (AIP); genetic disease with autosomal-dominant inheritance; patients with this disease have a 50 percent reduction in the activity of the enzyme porphobilinogen deaminase (PBG-D), which is sufficient for porphyrin synthesis. Triggers of a porphyria attack, which can last a few days but also months, are infections, drugs or alcohol. The clinical picture of these attacks presents as acute abdomen or neurological deficits, which can take a lethal course. The leading symptoms of acute porphyria are intermittent neurologic and psychiatric disturbances. Autonomic neuropathy is often in the foreground, causing abdominal colic (acute abdomen), nausea (nausea), vomiting or constipation (constipation), as well as tachycardia (heartbeat too fast: > 100 beats per minute) and labile hypertension (high blood pressure).
  • Vitamin deficiency:
    • Cobalamin (vitamin B12)
    • Folic acid
    • Nicotinic acid/niacin (vitamin B3)
    • Pyridoxine (vitamin B6)
    • Thiamine (vitamin B1)
  • Wernicke’s encephalopathy (synonyms: Wernicke-Korsakow syndrome; Wernicke’s encephalopathy) – degenerative encephaloneuropathic disease of the brain in adulthood; clinical picture: brain-organic psychosyndrome (HOPS) with memory loss, psychosis, confusion, apathy, and gait and stance unsteadiness (cerebellar ataxia) and eye movement disorders / eye muscle paralysis (horizontal nystagmus, anisocoria, diplopia)); vitamin B1 deficiency (thiamine deficiency).

Skin and subcutaneous (L00-L99).

Cardiovascular system (I00-I99)

Infectious and parasitic diseases (A00-B99).

  • AIDS (Acquired Immunodeficiency Syndrome).
  • Creutzfeldt-Jakob disease – disease affecting the brain, which is associated with BSE.
  • Gerstmann-Sträussler-Scheinker disease – disease affecting the brain, which is associated with BSE.
  • HIV infection
  • Syphilis (Lues) – sexually transmitted infectious disease.
  • Tuberculosis (consumption)

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

  • Hepatopathy – liver structural changes often due to cirrhosis (liver shrinkage).
  • Hepatic insufficiency (liver failure; e.g., after liver cirrhosis) → hepatic encephalopathy (central nervous system (CNS) dysfunction caused by acute or chronic liver disease)

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Crohn’s disease – chronic inflammatory bowel disease; it usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, several intestinal sections may be affected, which are separated by healthy sections from each other
  • Whipple’s disease – rare systemic infectious disease; caused by the gram-positive rod bacterium Tropheryma whippelii (from the group of actinomycetes), which can affect various other organ systems in addition to the obligately affected intestinal system and is a chronic recurrent disease; symptoms: Fever, arthralgia (joint pain), brain dysfunction, weight loss, diarrhea (diarrhea), abdominal pain (abdominal pain), and more. → Malabsorption syndrome
  • Celiac disease (gluten-induced enteropathy) – chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is based on hypersensitivity to the cereal protein gluten → malabsorption syndrome.

Neoplasms – tumor diseases (C00-D48).

  • Brain tumors (ventricle III or in the hypothalamus).
  • Brain tumors, unspecified
  • Brain metastases
  • Insulinoma – in the majority of cases benign neoplasm in the area of the pancreas (pancreas) → hypoglycemia (low blood sugar)
  • Metastases (daughter tumors).

Psyche – nervous system (F00-F99; G00-G99)

  • Alcohol dependence
  • ALS (amyotrophic lateral sclerosis)-Parkinson’s dementia complex.
  • Anxiety disorders
  • Alzheimer’s dementia
  • Chorea-Huntington – genetic neurological disease with increasing degradation of brain mass.
  • Dementia pugilistica – dementia caused by repeated traumatic brain injury (injury).
  • Depression
  • Dialysis dementia
  • Encephalitis (inflammation of the brain)
  • Encephalopathy: uremic, hepatic, pancreatic.
  • Epilepsy – recurrent (recurrent) seizures.
  • Frontotemporal dementia (FTD; synonyms: Pick’s disease, Pick’s disease; Pick’s disease) – a neurodegenerative disease usually occurring before the age of 60 in the frontal lobe (frontal lobe) and temporal lobe (temporal lobe) of the brain, resulting in progressive personality decline; belongs to the group of frontotemporal lobular degenerations; three clinical subtypes caused by frontotemporal neuronal decline are distinguished: 1. Frontotemporal dementia (FTD), 2. semantic dementia, and 3. progressive non-fluent aphasia; FTD is often misdiagnosed as Alzheimer’s disease or Parkinson’s disease.
  • Gerstmann-Sträussler-Scheinker syndrome (GSSS) – transmissible spongiform encephalopathy caused by prions; it resembles Creutzfeldt-Jakob disease; disease with ataxia (gait disorder) and progressive dementia.
  • Hallervorden-Spatz syndrome – genetic disease with autosomal recessive inheritance, which leads to neurodegeneration with iron deposition in the brain, resulting in mental retardation and early death; onset of symptoms before the age of 10.
  • Brain abscess – encapsulated collection of pus in the brain.
  • Hydrocephalus (hydrocephalus; pathological enlargement of the liquid-filled fluid spaces (cerebral ventricles) of the brain).
  • Corticobasal (or corticobasal) degeneration (CBD) – slowly progressive neurodegenerative disease.
  • Leigh encephalomyelopathy – genetic neurological disorder of early infancy.
  • Leukodystrophy – disease of the central nervous system characterized by metabolic disorders.
  • Lewy body dementia – dementia with special histological picture.
  • Meningoencephalitis – combined inflammation of the brain (encephalitis) and meninges (meningitis).
  • Parkinson’s disease
  • Multi-infarct dementia – dementia due to brain damage after multiple strokes.
  • Multiple sclerosis (MS) – neurological disease that can lead to paralysis.
  • Multisystem atrophy – neurological disease associated with parkinsonism.
  • Neuroses
  • Normal pressure hydrocephalus – brain changes due to a decrease in brain matter and simultaneous increase in cerebrospinal fluid (nervous fluid).
  • Neuroacanthocytosis – syndrome with many different neurological and psychiatric signs of disease.
  • Post-traumatic stress disorder (PTSD) – in the long-term course more frequent limitations of cognitive function.
  • Progressive multifocal encephalopathy – brain changes caused by papovavirus.
  • Progressive supranuclear palsy – neurological disease associated with dementia.
  • Psychosis
  • Schizophrenia
  • Sleep apnea
  • Subcortical arteriosclerotic encephalopathy (SAE) – dementia due to vascular changes with arteriosclerosis in the brain.
  • Subacute sclerosing panencephalitis – generalized encephalitis (inflammation of the brain) usually caused by measles infection.
  • Cerebral vasculitis (cerebral vasculitis).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Uremia (occurrence of urinary substances in the blood above normal levels) → uremic encephalopathy.

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Renal insufficiency (kidney weakness).

Causes (external) of morbidity and mortality (V01-Y84).

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Postoperative cognitive dysfunction (POCD) – transient (“temporary”) postoperative disorder associated with poorer convalescence after surgery.
  • Traumatic brain injury (STH, traumatic brain injury).
  • Heavy metal poisoning

Medication

  • See “Causes” under medications

Environmental pollution – intoxications (poisoning).

  • Anoxia (complete absence of oxygen in the tissues), for example, due to anesthesia incident / poisoning with narcotics (drugs used during anesthesia).
  • Radiofrequency electromagnetic fields (e.g., cell phones; smartphones, cell phones) – cumulative brain RF EMF exposure from cell phones may adversely affect the development of figural memory in adolescents
  • Carbon monoxide
  • Solvent encephalopathy (brain changes due to exposure to solvents):
    • Benzene (e.g., contained in: motor gasoline).
    • Chlorinated hydrocarbons (e.g., contained in: Solutions for dry cleaning, cleaning agents for engines and in paint and grease removers).
    • Petroleum-based solvents (e.g. contained in: Furniture care products and carpet adhesives as well as paints and varnishes).
  • Drug-induced hyponatremia (too low a level of sodium in the blood) such as by diuretics (diuretics that promote the formation and excretion of urine), antiepileptic drugs or occasionally by ACE inhibitors – this can lead to secondary dementia
  • Perchloroethylene
  • Mercury
  • Heavy metal poisoning (arsenic, lead, mercury, thallium).

Further

  • Cardiovascular arrest
  • Altitude sickness
  • Polypharmacotherapy (regular daily use of five or more medications).
  • Diver’s disease