Early diagnosis of dementia via a two-step screening and diagnostic procedure.
We propose a two-step process for the assessment of dementia using standardized instruments. The family physician performs a screening consisting of taking a medical history, gathering information from relatives and friends of the patient, and administering the combined Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). Specialists examine patients with suspected dementia to confirm the diagnosis of dementia and, after a thorough differential diagnostic process, provide the family physician with recommendations for treatment. Specialists should perform neurological and psychiatric examinations, imaging (computer-assisted tomography [CT], magnetic resonance imaging [MRI]), and laboratory work-up. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) core neuropsychological battery is proposed to serve as a minimal data set that is internationally compatible. In addition, we recommend the Nurses' Observation Scale for Geriatric Patients (NOSGER) as a standard tool for functional assessment.
Stähelin
H B
HB
Memory Clinic, Geriatric University Hospital, Kantonsspital, Basel, Switzerland.
Monsch
A U
AU
Spiegel
R
R
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D013997:Time Factors; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed