Some Major Causes Of The Syndrome Of Dementia Introduction

As already noted, there are many brain diseases that can cause dementia. In this chapter we are primarily interested in the dementing diseases associated with aging and will focus on the four most common dementing diseases: Alzheimer's disease, frontotem-poral dementia, vascular dementia, and dementia with Lewy bodies.

TABLE 15.2. The Dementia "Work-up"

Studies that should be done routinely in all

1.

History and physical exam

patients

2.

Neurological exam

3.

Mental status testing

4.

Bi2 level

5.

Thyroid function tests

6.

Noncontrasted CT or MRI

Studies commonly done in clinical practice,

1.

Complete blood count

but costs/benefits not established by

2.

Basic chemistries (electrolytes, renal

research

function tests, liver function tests)

3.

Folate level

4.

Sedimentation rate

Studies that can be helpful with differential

1.

Neuropsychological assessment

diagnosis but may not be commonly

2.

Functional neuroimaging (SPECT, etc.)

available outside referral centers

Studies that should be done only when

1.

Syphilis tests

suspicion for a specific illness is high

2.

HIV test

3.

Heavy-metal screening

4.

Cerebrospinal fluid analysis (e.g., for

14-3-3 protein associated with

Creutzfeldt-Jakob disease)

5.

EEG (e.g., in patient with suspected

seizures)

Studies mainly of interest in

1.

Genetic testing (e.g., APOE genotyping)

research/clinical usefulness has not been

2.

Cerebrospinal fluid analysis for

established by research

AD-specific biomarkers (e.g.,

beta-amyloid and tau)

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