title: [Cost effectiveness of the diagnostic study of dementia in an extra-hospital Neurology service].
abstract: OBJECTIVE
  The purpose of this study was to analyse the cost effectiveness of the complementary tests in the diagnosis of reversible causes of dementia in an extra-hospital Neurology service.
  
  
  METHODS
  Patients referred to the Neurology service from Primary Care with a diagnosis of dementia according to DSM-III-R criteria. The following routine complementary tests were performed: 1. Analyses, including blood count, biochemical study, vitamin B12 and folic levels, thyroid hormones, and syphilis serodiagnosis; 2. Neuroimaging study, consisting in computerised axial tomography or cranial magnetic resonance.
  
  
  RESULTS
  A total of 269 consecutive patients diagnosed as suffering from dementia were included in the study. The mean age of the patients was 74.5 years (49-94 years) and 61% were females. The most frequent cause of dementia was Alzheimer's disease (79.9%). In all, 31 patients presented potentially reversible conditions (11.5%), but if we exclude depression, the dementia was only reversible in one patient (0.4%).
  
  
  CONCLUSIONS
  The percentage of patients with reversible causes of dementia in the field of extra-hospital neurology is low. The diagnostic study must be individualised according to the clinical suspicion.
authors.affiliation: Sección de Neurología, Hospital Vega Baja, Orihuela, Alicante, Spain. aperezs@mac.com
authors.forename: A P
authors.initials: AP
authors.lastname: Sempere
authors.forename: J M
authors.initials: JM
authors.lastname: Callejo-Domínguez
authors.forename: C
authors.initials: C
authors.lastname: García-Clemente
authors.forename: M C
authors.initials: MC
authors.lastname: Ruipérez-Bastida
authors.forename: S
authors.initials: S
authors.lastname: Mola-Caballero de Roda
authors.forename: N
authors.initials: N
authors.lastname: García-Barragán
authors.forename: R
authors.initials: R
authors.lastname: Vela-Yebra
authors.forename: J J
authors.initials: JJ
authors.lastname: Flores-Ruiz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D003955:Diagnostic Tests, Routine / Q000191:economics*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital