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Other Investigations

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Lab Tests

  • routine labs:  complete blood count, fasting blood sugar, thyroid stimulating hormone, calcium, electrolytes, urea and creatinine

  • specific labs:  B12, folate levels, liver function tests

  • for most patients who have a clinical presentation consistent with AD with typical cognitive symptoms or presentation, only the above basic set of tests need to be completed

  • extensive investigations are not required unless a reversible cause of dementia is suspected [8]

Brain Imaging

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  • Computerized Tomography (CAT):  role in detecting certain causes of dementia such as VaD, tumor, NPH or subdural hematoma

  • Magnetic Resonance Imaging (MRI):  helps to visualize white matter lesions

  • Functional Imaging:  Positron Emission Technology (PET scans) and Functional Magnetic Resonance Imaging (fMRI):  mainly used for research purposes only and not in clinical settings

for more information on neuroimaging, follow this link.[5]

Others

  • EEG:  used in patients in whom seizure disorder is suspected

  • lumbar puncture to analyze the cerebrospinal fluid (CSF):  used to rule out infection, inflammation, malignancy

  • in complex cases, a referral to specialists such as geriatrics, psychogeriatrics or neurology may be required

 

How well do you know your diagnostic tools ?

 

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5. Harvard Medical School Neuroimaging Primer http://www.med.harvard.edu/AANLIB/hms1.html accessed: October 4, 2006

8. Patterson CJS, Gauthier S, Bergman H, Cohen CA, Feightner JW, Feldman H, Hogan DB. The recognition, assessment and management of dementing disorders: conclusions from the Canadian Consensus Conference on Dementia. Canadian Medical Association Journal 1999; 160 Suppl 12:S1-15.

All references for this section