Initial evaluation of the patient with suspected dementia

Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the United States will continue to grow. Alzheimer's disease and vascular dementia account for the majority of cases of dementia. After a thorough history and physical examin...

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Bibliographic Details
Published inAmerican family physician Vol. 71; no. 9; p. 1745
Main Authors Adelman, Alan M, Daly, Mel P
Format Journal Article
LanguageEnglish
Published United States American Academy of Family Physicians 01.05.2005
Subjects
Alzheimer's disease
Brain - diagnostic imaging
Brain - pathology
Cognition - physiology
Dementia
Dementia - blood
Dementia - diagnosis
Dementia - psychology
Diagnosis, Differential
Humans
Intelligence Tests
Magnetic Resonance Imaging
Medical History Taking - methods
Neuropsychological Tests
NMR
Nuclear magnetic resonance
Older people
Physical examinations
Reproducibility of Results
Thyrotropin - blood
Tomography
Tomography, X-Ray Computed
Vitamin B 12 - blood
United States > US
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Summary:Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the United States will continue to grow. Alzheimer's disease and vascular dementia account for the majority of cases of dementia. After a thorough history and physical examination, including a discussion with other family members, a baseline measurement of cognitive function should be obtained. The Mini-Mental State Examination is the most commonly used instrument to document cognitive impairment. Initial laboratory evaluation includes tests for thyroid-stimulating hormone and vitamin B12 levels. Structural neuroimaging with noncontrast computed tomography or magnetic resonance imaging also is recommended. Other testing should be guided by the history and physical examination. Neuropsychologic testing can help determine the extent of cognitive impairment, but it is not recommended on a routine basis. Neuropsychologic testing may be most helpful in situations where screening tests are normal or equivocal, but there remains a high level of concern that the person may be cognitively impaired.
ISSN:0002-838X