ABSTRACT
Patients presenting for the first time with dementia often have little insight into their problem and it is the relatives who make the appointment or bring them to the readers. The readers will make the diagnosis mainly from the history that the relatives provide, but the neurological examination is important for confirming this. As with the aphasic patient, their approach to the patient with cognitive impairment will make allowance for the fact that there are problems with communication and the patient is anxious or alarmed. Sit beside the patient and make every effort by their manner to put them at their ease. Better still, have a relative or friend present who can provide moral support and fill in the aspects of the history which the patient is unable to provide; patients with dementia often lack insight into their problem.
