ABSTRACT
The family history can be of prime importance in a number of dementing illnesses, particularly in genetically inherited disorders such as Huntington’s disease. The antecedent history may contain clues of great significance, and even slight head injury can lead to subdural haematoma (bleeding below the dural layer covering the brain), resulting in damage to nerve and brain tissue, and possibly subsequent infarcts or meningitis. It is also important to record fitting, faints and seizures, and neglect of diet may rule out some diagnoses or explain some symptoms (see Figures 8.1 and 8.2 for a guide to questioning the patient/carer). In all, a comprehensive account of the patient’s lifestyle can considerably assist in an accurate diagnosis. In fact, very often a diagnosis of dementia is made after exclusion of other physical symptoms and organic origins. Special care should be taken to rule out the possibility of a differential diagnosis, for example between dementia and depression. Tools such as the Beck Depression Inventory (Beck & Steer, 1987) may be useful when used in conjunction with the clinical interview by a trained professional, for example a clinical psychologist.
