Journal of Alzheimers Disease & Parkinsonism
Open Access

Abstract

Case: This is the case report of Mr. Ashoke 61/M, his chief concerns are forgetfulness and having problems in taking judgments.

Psychiatric History: Nothing significant other than chronic mild anxiety according to his wife. History revealed mild forgetfulness and difficulty in making plans since adolescence.

Present Medical History: Type-2 diabetes for last 14 years and hypertensive; had 2 brief episodes of probable TIA.

Past History: No significant medical illness. Neuropsychological Testing: MMSE and MoCA (Montreal Cognitive Assessment) scores were 21 and 22 respectively consistent with a diagnosis of VCIND. However, as he has a longitudinal h/o some executive dysfunctions including working memory, he was walked through DIVA scoring and Conner’s Adult ADHD rating scale and the scores were significantly in favor of an Adult ADHD diagnosis (DIVA score >4 and Conner’s Adult ADHD rating scale t score >65).

Discussion: VCIND (Vascular Cognitive Impairment Not Dementia) is a likely diagnosis with history of diabetes, hypertension and TIAs (even if his TIAs are image negative), but given a chronic persistent h/o mild cognitive impairment since adolescence, a differential diagnosis of Adult ADHD should be considered. Hence, those cases of VCIND (Vascular Cognitive Impairment Not Dementia) and MCI (Minimal Cognitive Impairment) with chronic h/o memory impairment, ADHD should be excluded.

Biography

Debanjan Pan is a Fellow of the Indian Psychiatric Society, Member of the Indian Association of Child & Adolescent Mental Health, Member of The Alzheimer & Related Disease Society Of India, International Associate of The Royal College Of Psychiatrist (RCPsych) and Fellow of The American Psychiatric Association (APA). He completed his Post-graduate Oversees Specialty Training Fellowship (POST Fellow) in CAMH, St. Vincent's Hospital, Melbourne, University of Melbourne; Medical Graduate from RG Kar Medical College 1990; DCH from Calcutta University (1995); DPM from Calcutta University (2001) and; MD from Calcutta University (2005). Presently, he is serving as Director of Saltlake Mindset Organization (www.saltlakemindset. org) a noted mental health treatment unit in Kolkata, West Bengal, India. He is also attached as a Senior Consultant Psychiatrist at The South Heart Clinic and Diagnostic Center, Near Jadavpur and Theism Polyclinic, Dumdum. His interests include Child & Adolescent Mental Health and Cognitive Behavioral Therapy. He has presented several papers at AAGP 2012 & 2013; World ADHD Congress 2013; ISAD Congress, Berlin 2014; APA Congress, 2015 and; Toronto and European Congress of Psychopharmacology Vienna, Sept, 2016. He is a regular Columnist on topics of mental health related issues for common people in popular dailies (Aajkal, Bartaman, Pratidin) & other magazines like Saptahik Bartaman and Arogyo Katha.

E-mail: debanjandoc@gmail.com