title: The use of MRI, CT and lumbar puncture in dementia diagnostics: data from the SveDem Registry.
abstract: OBJECTIVE
  The use of structural brain imaging [computed tomography (CT)/magnetic resonance imaging (MRI)] and the analysis of cerebrospinal fluid biomarkers are included in the guidelines for the diagnosis of dementia. The influence of variables such as age, gender and disease severity on the use of MRI, CT and lumbar puncture (LP) for the differential diagnosis of dementia and the consonance with the recommendations of the Swedish national guidelines were investigated.
  
  
  METHODS
  From the National Swedish Dementia Registry (SveDem), 17,057 newly diagnosed dementia patients were included in our study, with the majority from specialist care units (90%).
  
  
  RESULTS
  In the diagnostic workup, a CT was performed in 87%, MRI in 16% and LP in 40% of the cases. Age (p < 0.001) and cognitive status (p < 0.001) significantly influenced the use of MRI, CT or LP. Older patients with severe dementia were often investigated with CT. LP and MRI were used more often when less common dementia disorders were suspected.
  
  
  CONCLUSIONS
  Our findings indicate that age, severity of cognitive impairment and the type of dementia disorder suspected are determinants for the choice of CT, MRI or LP. The majority of the dementia workups in specialist care units follow the recommendations of the Swedish national guidelines where CT is performed as a basic workup, and MRI and LP are chosen when extended workup is needed. .
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Farshad
authors.initials: F
authors.lastname: Falahati
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Fereshtehnejad
authors.forename: Dorota
authors.initials: D
authors.lastname: Religa
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Eric
authors.initials: E
authors.lastname: Westman
authors.forename: Maria
authors.initials: M
authors.lastname: Eriksdotter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012042:Registries; D013129:Spinal Puncture; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers