Investigations & Diagnosis

Initial Assessment:

• Cognitive assessments: Mini-Cog, MIS, 10-CS, 6-CIT
• Blood tests: ESR, CRP, FBC, U&E, HbA1c, LFTs, TFTs, B12, folate
• Other tests: MSU, chest X-ray, ECG, syphilis, HIV
• Specific symptoms are linked to certain types of dementia:
  • Vascular D. – Depression, Delusion, Extensive mood lability (personality changes), Cerebrovascular history
  • Lewy Body D. – Most common in older people, similar symptoms to Alzheimer’s, spontaneous fluctuation in cognitive abilities, visual hallucinations, Parkinsonism
  • Frontotemporal D. – Occurs especially in younger people, personality & behavioural changes ( e.g., apathy, social or sexual disinhibition)
  • Alzheimer’s D. – Short-term memory loss, poor ability to complete executive tasks, dysphasia, aphasia, apraxia, agnosia

Secondary Care:

• CT scan
• MRI
• SPECT
• CSF testing

Rule out other causes:

• Depression
• Delirium
• Hypothyroidism
• Addison’s disease
• Hypopituitarism
• Vitamin deficiencies
• Infections
• Autoimmune conditions
• Transient epileptic amnesia
• Medication effects (benzodiazepines, opioids, anticholinergics, antiepileptics,
corticosteroids, NSAIDs)