Evaluation of the Patient with Dementia
Routine Evaluation | Optional Focused Tests | Occasionally Helpful Tests |
---|---|---|
History | Psychometric testing | EEG |
Physical examination | Chest x-ray | Parathyroid function |
Laboratory tests | Lumbar puncture | Adrenal function |
Thyroid function (TSH) | Liver function | Urine heavy metals |
Vitamin B12 | Renal function | RBC sedimentation rate |
Complete blood count | Urine toxin screen | Angiogram |
Electrolytes | HIV | Brain biopsy |
CT/MRI | Apolipoprotein E | SPECT |
RPR or VDRL | PET | |
Lab screen for autoantibodies | ||
Diagnostic Categories | ||
Reversible Causes | Irreversible/Degenerative Dementias | Psychiatric Disorders |
Examples | Examples | Depression |
Hypothyroidism | Alzheimer's | Schizophrenia |
Thiamine deficiency | Frontotemporal dementia | Conversion reaction |
Vitamin B12 deficiency | Huntington's | |
Normal-pressure hydrocephalus | Dementia with Lewy bodies | |
Subdural hematoma | Vascular | |
Chronic infection | Leukoencephalopathies | |
Brain tumor | Parkinson's | |
Drug intoxication | ||
Autoimmune encephalopathy | ||
Associated Treatable Conditions | ||
Depression | Agitation | |
Seizures | Caregiver burnout | |
Insomnia | Drug side effects |
Abbreviations: PET, positron emission tomography; RPR, rapid plasma reagin (test); SPECT, single-photon emission computed tomography; TSH, thyroid-stimulating hormone; VDRL, Venereal Disease Research Laboratory (test for syphilis).