Health of Older People
Uncomplicated Dementia Pathway - Diagnostic Clarification
Specialist Referral Options:
- Cognitive enhancing medication
- CT scan
The main reason for imaging is to identify and rule out pathologies other than dementia of the Alzheimers' 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 in conjunction with other factors listed.
- History of the combination of urinary incontinence, balance and gait disorder suggesting possible NPH (Normal Pressure Hydrocephalus).
- Gait disturbance not otherwise explained.
- Intellectual disability.
If a CT is indicated an eReferral can be made via BestPractice.
For further advice regarding diagnostic difficulties or other clinical concerns please send in an "Advice only" referral to the Bay of Plenty District Health Board Memory Service/HIA depending on clinical presentation.
Last updated : Wednesday, December 20, 2017
Next review date : Thursday, December 20,2018
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