Box 1.

Characteristics, symptoms and signs that suggest neurodegenerative etiology of a psychiatric state

• Historical:	• Cognitive symptoms:
– Later than typical age at onset	– Aphasia
– Puzzling “atypical” features	– Apraxia
– Family history of dementia, parkinsonism, or other motor disorder	– Visual complaints (other than hallucinations)
	– Spatial disorientation
– Unusual prodrome, e.g., insomnia, hyperphagia	– Incontinence
– Rapid evolution
	• Physical/motor signs
	– Abnormal posture and movement
• Mental status:	– Frequent falls at early stage
– Poor insight	– Frequent (myoclonic) jerking
– Apathy/indifference	– Progressive motor weakness
– Compulsions without obsessions	– Declining motor coordination
– Visual hallucinations	– Left-right asymmetry