Diagnosing dementia in rural New South Wales.

OBJECTIVE

Review of dementia screening case profiles that included brain blood flow imaging to determine contribution to diagnosis.

DESIGN

Retrospective medical case audit.

SETTING

Rural New South Wales.

PARTICIPANTS

Eighty-eight rural patients who underwent investigations for dementia diagnosis.

MAIN OUTCOME MEASURE

Contribution of brain blood flow imaging (single photon emission tomography, SPECT) to the dementia screening regime.

RESULTS

The age range of those referred was 21-88 years, the average being 70 years. There were 44 men and 44 women. Vascular causes of dementia accounted for 27% of all those referred for brain blood imaging. Senile dementia of the Alzheimer's type accounted for 40% of all referrals. The occurrence of mixed disease was 6%. Matching neuropsychological reports and computer tomography were available for 18 of the blood flow studies. Of these, 65% were in agreement or semi-agreement for the diagnostic outcome. Only five studies failed to reach consensus. GPs were responsible for 31% of the imaging referrals, and the remaining referrals were from the regions: two gerontologists, three physicians and two neurologists.

CONCLUSIONS

Brain blood flow imaging did contribute to the final diagnosis of dementia type for these patients, influencing patient management.