Health of Older People  |  Uncomplicated Dementia Pathway - Appropriate Investigations




Health of Older People

Uncomplicated Dementia Pathway - Appropriate Investigations

  • Labs

  1. U/E
  2. CBC
  3. LFT
  4. TSH
  5. CRP (if under 75 consider homocysteine)
  6. Calcium
  7. B12/Folate
  8. Glucose (HbA1c)
  9. MSU
  10. RPR for syphilis

  • Consider ECG

  • Imaging

The main reason for imaging is to identify and rule out pathologies other than dementia of the Alzheimer's type and Vascular dementia; we would recommend brain CT scanning if there are one or more of the following in addition to cognitive decline (for example a MOCA score of less than 26 or similar decline using validated assessment tools): 

  1. Age less than 65
  2. Unexpected rapid decline in cognition function or onset significant headache
  3. Any localizing or unexplained neurological signs
  4. Recent head trauma
  5. History of cancer with high risk of intracranial metastases (particularly lung, breast, melanoma, head & neck cancers, colon/pancreatic, genitourinary and lymphoma)
  6. Use of anticoagulants/history of bleeding conjunction with other factors listed
  7. History of the combination urinary incontinence, balance and gait disorder suggesting possible NPH
  8. Gait disturbance not otherwise explained
  9. Intellectual disability

 

If a CT is indicated an eReferral can be made via BestPractice.

The above recommendations as per Midland Region Community Radiology Access Criteria (2014).



Last updated : Tuesday, December 12, 2017
Next review date : Wednesday, December 12,2018


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