[Cost effectiveness of the diagnostic study of dementia in an extra-hospital Neurology service].
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.
Sempere
A P
AP
Sección de Neurología, Hospital Vega Baja, Orihuela, Alicante, Spain. aperezs@mac.com
Callejo-Domínguez
J M
JM
García-Clemente
C
C
Ruipérez-Bastida
M C
MC
Mola-Caballero de Roda
S
S
García-Barragán
N
N
Vela-Yebra
R
R
Flores-Ruiz
J J
JJ
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