Objective: To describe an approach to the diagnosis of dementia based on effective assessment methods.
Design: We reviewed the literature and summarized the available diagnostic and prognostic studies of dementia that may be useful to the primary-care physician.
Results: Although controversy exists about certain aspects of the diagnostic workup, exclusion of potentially reversible causes of dementia is essential. Laboratory studies (for example, for detection of underlying metabolic abnormalities) and neuroimaging of the brain may be useful. The pattern of onset and the temporal course of the disease may suggest a cause and help direct the investigation. Functional losses can substantially impair the patient's ability to live independently.
Conclusion: Dementia can be mistakenly considered as part of the normal aging process, and diagnosis necessitates a thorough, although not exhaustive, approach. Early identification of dementing illnesses improves the outcome for reversible disease and may also enhance the management of incurable dementias.