physical examination for Multi-infarct Dementia

The physical examination should be focused on the cardiovascular system and neurologic localizing signs.

• The temporal arteries may show decreased pulsatility, local tenderness, and thickening associated with giant cell arteritis.


• Funduscopic examination provides important information regarding end-organ effects of hypertension and diabetes mellitus.


• Cardiac auscultation may detect rhythmic and valvular abnormalities.


• Low scores on a standardized instrument (eg, Mini Mental Status Examination, Short Blessed questionnaire) can provide corroborating evidence of a cognitive disturbance.


• Spasticity, hemiparesis, visual field defects, pseudobulbar palsy, and extrapyramidal signs confirm focal pathology.