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How does additional diagnostic testing influence the initial diagnosis in patients with cognitive complaints in a memory clinic setting?
- Source :
-
Age and ageing [Age Ageing] 2015 Jan; Vol. 44 (1), pp. 72-7. Date of Electronic Publication: 2014 May 20. - Publication Year :
- 2015
-
Abstract
- Background: patients suspected of dementia frequently undergo additional diagnostic testing (e.g. brain imaging or neuropsychological assessment) after standard clinical assessment at a memory clinic. This study investigates the use of additional testing in an academic outpatient memory clinic and how it influences the initial diagnosis.<br />Methods: the initial diagnosis after standard clinical assessment (history, laboratory tests, cognitive screening and physical and neurological examination) and the final diagnosis after additional testing of 752 memory clinic patients were collected. We specifically registered if, and what type of, additional testing was requested.<br />Results: additional testing was performed in 518 patients (69%), 67% of whom underwent magnetic resonance imaging, 45% had neuropsychological assessment, 14% had cerebrospinal fluid analysis and 49% had (combinations of) other tests. This led to a modification of the initial diagnosis in 17% of the patients. The frequency of change was highest in patients with an initial non-Alzheimer's disease (AD) dementia diagnosis (54%, compared with 11 and 14% in patients with AD and 'no dementia'; P < 0.01). Finally, after additional testing 44% was diagnosed with AD, 9% with non-AD dementia and 47% with 'no dementia'.<br />Conclusion: additional testing should especially be considered in non-AD patients. In the large group of patients with an initial AD or 'no dementia' diagnosis, additional tests have little diagnostic impact and may perhaps be used with more restraint.<br /> (© The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Academic Medical Centers
Age Factors
Aged
Aged, 80 and over
Aging
Alzheimer Disease diagnosis
Alzheimer Disease psychology
Biomarkers cerebrospinal fluid
Cognition Disorders cerebrospinal fluid
Cognition Disorders psychology
Databases, Factual
Dementia cerebrospinal fluid
Dementia psychology
Female
Humans
Magnetic Resonance Imaging
Male
Neurologic Examination
Neuropsychological Tests
Predictive Value of Tests
Cognition
Cognition Disorders diagnosis
Dementia diagnosis
Memory
Outpatient Clinics, Hospital
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2834
- Volume :
- 44
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Age and ageing
- Publication Type :
- Academic Journal
- Accession number :
- 24847028
- Full Text :
- https://doi.org/10.1093/ageing/afu053