Guidelines for Assessment of Dementia

Bermingham SL. The appropriate use of neuroimaging in the diagnostic work-up of dementia: an economic literature review and cost-effectiveness analysis. Ontario health technology assessment series. 2014;14(2):1. Dementia can be caused by a number of different pathological processes that can be difficult to distinguish by clinical evaluation alone. Further investigation, including structural imaging of the brain, is often undertaken to establish the cause of illness for patients who meet criteria for dementia according to the DSM, ICD, or NINCDS-ADRDA. Several committees have published recommendations for the diagnostic evaluation of people with dementia. (1-7) In Ontario, the most frequently used guidelines include those developed by the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCC) (4) and the American Academy of Neurology (AAN). (5) Both recommend a complete neurologic history, neuropsychological assessment, and laboratory work-up as essential components of the diagnostic pathway. However, they differ with respect to who should receive neuroimaging and whether this should be performed using computed tomography (CT) or magnetic resonance imaging (MRI) (Table 1).