© 2001 Evidence-Based Mental Health
Clinical evaluation led to a definitive diagnosis in 95% of patients presenting with dementia
Massoud F, Devi G, Moroney JT, et al.The role of routine laboratory studies and neuroimaging in the diagnosis of dementia: a clinicopathological study.J Am Geriatr Soc 2000 Oct;48:1204–10.[Medline]
QUESTION: In patients who present with dementia, what are the results of the dementia workup and how do these compare with the neuropathological diagnoses at autopsy?
Cohort study with follow up to the death of the patient (mean follow up 4 y).
A tertiary care centre for patients with cognitive complaints in New York, USA.
61 patients (mean age 69 y, 59% men) with cognitive complaints. Autopsy was available for the entire sample.
Patients had a clinical evaluation that included a structured neurological, functional, and psychiatric examination and a series of laboratory tests (complete blood count, serum electrolytes, liver and renal function tests, serum B12 folate, Venereal Disease Research Laboratory, and thyroid function tests). 60 patients had brain imaging (computerised axial tomography [CT] scan or magnetic resonance imaging [MRI] scans). The following were used: DSM-III-R for dementia, NINCDS-ADRDA for Alzheimer's disease (AD), and NINCDS and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences criteria for vascular dementia. The presence of concomitant AD with cerebrovascular disease on clinical evaluation or neuroimaging was classified as possible
Baycrest Centre for Geriatric Care Toronto, Ontario, Canada
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Neurology
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