Assessment of suspected dementia

At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1 998), a group of neurologists, geriatricians, and psychiatrists met to cons ider guidelines for evaluation of dementia in Canada. This review paper for med a background paper for their discussion of dementia diagnosis. These ex perts from across the country concluded that diagnosis of suspected dementi a cases continued to rest on skilled clinical assessment. Mental status exa m, preferably in some quantifiable form, has become an essential part of th e assessment. Selected laboratory tests are advisable in all cases (CBC, TS H, electrolytes, calcium, and glucose), but the CCCD continued to advise th at CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer's disease. The growing li st of other diagnostic measures with potential usefulness in diagnosis of A lzheimer's disease or dementia in general was reviewed. but the evidence wa s judged as insufficient to support routine use of these tests by physician s. As new treatments for Alzheimer's disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment , Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Gui delines to aid in differential diagnosis are presented.