Diagnostic scheme
The diagnostic investigations include measurements of cognitive and functional performance, plus examinations to detect any possible pathophysiological features:
- Interview with the patient performance of psychometric tests (e.g. clock test, MMSE, ) to assess cognitive function, the ability to perform everyday tasks, behavior, overall function and the disease stage.
- Interview with the carer/person looking after the patient to assess the patient's findings objectively and to assess the extent to which the carer/person looking after the patient suffers psychologically, physically or socially on account of the patient's illness.
- Physical examination to assess mobility, reflexes, hearing, visual acuity and general health (e.g. cardiovascular system: ECG, blood pressure, lung status, risk factor profile: hypertension, diabetes mellitus, smoking, alcohol, obesity).
- Blood tests (e.g. erythrocyte sedimentation rate, minor blood count, cholesterol, electrolytes, urea,creatinine, thyroid function) to exclude other diseases which may cause dementia-like symptoms such as nutrition-induced diseases and endocrinological disturbances such as kidney and liver disease or infections.
- Psychiatric examination to exclude depression and delirium and to assess accompanying depressive symptoms.
- Computer tomography (CT) or magnetic resonance tomography (MRT) in order to find possible causes of dementia, such as vascular events, and to exclude other diseases by differential diagnosis.
Other investigations useful when diagnosing dementia are:
- Lumbar puncture to exclude inflammation and Creutzfeldt-Jakob disease and to detect pathologically reduced levels of soluble beta-amyloid (A_) or pathologically elevated levels of the tau-protein associated with AD [Kurz et al., 2002].
- Electroencephalography (EEG)
- Positron-emission tomography (PET) and single-photon-emission computer tomography (SPECT) for the assessment of blood supply, glucose metabolism and receptor density in AD.
