Health of Older People
Uncomplicated Dementia Pathway - Appropriate Investigations
- CRP (if under 75 consider homocysteine)
- Glucose (HbA1c)
- RPR for syphilis
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):
- Age less than 65
- Unexpected rapid decline in cognition function or onset significant headache
- Any localizing or unexplained neurological signs
- Recent head trauma
- History of cancer with high risk of intracranial metastases (particularly lung, breast, melanoma, head & neck cancers, colon/pancreatic, genitourinary and lymphoma)
- Use of anticoagulants/history of bleeding conjunction with other factors listed
- History of the combination urinary incontinence, balance and gait disorder suggesting possible NPH
- Gait disturbance not otherwise explained
- 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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