Investigations

At the initial assessment, patients with dementia should be investigated for other disorders that could complicate, exacerbate, or be confused with AD. A dementia screen might include routine biochemistry, thyroid function tests, vitamin B 12 and folate estimations, and a full blood count; many would also include syphilis serology, although the frequency of abnormal findings is low. A CT brain scan is not necessary in many cases and is not a required investigation in the NINCDS-ADRDA classification, although worsening atrophy on CT is supportive evidence. Functional scanning (single-photon emission CT (SPECT) in particular) can be useful where regional dementias are suspected, and magnetic resonance imaging can provide supportive evidence where vascular dementia is a possibility. An EEG is nearly always non-specifically abnormal even in the early stages of AD, in contrast with frontotemporal degenerations where an EEG remains unaffected at a broadly equivalent severity. This can help to distinguish the conditions, particularly where there is neuroimaging evidence of regional insufficiency.

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