The added value of neuropsychologic tests and structural imaging for the etiologic diagnosis of dementia in Italian expert centers

Cristina Geroldi, Elisa Canu, Amalia C. Bruni, Gloria Dal Forno, Raffaele Ferri, Carlo Gabelli, Roberta Perri, David Iapaolo, Osvaldo Scarpino, Elena Sinforiani, Orazio Zanetti, Giovanni B. Frisoni

Research output: Contribution to journalArticle

Abstract

Aim of the study was to assess the added diagnostic value of neuropsychologic tests and structural neuroimaging (computed tomography or magnetic resonance) in the routine clinical assessment of demented patients in Italian expert centers. Nine centers were involved, located across the whole country (3 in Northern, 3 in Central, and 3 in Southern Italy). Diagnostic pathways were tracked for 474 patients with an expert diagnosis of neurodegenerative or vascular dementia (age 76 ± 8; 62% females; Mini-Mental State Examination 17.70 ± 5.7). The contribution of neuropsychology and structural neuroimaging to diagnosis was estimated as "number needed to test" (NNT), denoting the number of patients who need to undergo such procedures to improve expert diagnosis of 1 unit. Expert physicians reached their diagnosis without resorting to structural imaging examinations and neuropsychologic tests in 93% of Alzheimer disease (AD) and 76% of non-AD dementias. The completion of the extended assessment led to improvement of diagnostic accuracy in both cases; the NNT was 15.3 (95% confidence interval: 10.4-29.1) and 4.1 (3.0 to 6.5) for AD and non-AD diagnoses. The added value of structural imaging and neuropsychologic testing in the routine clinical assessment of demented patients is substantial in both AD and non-AD cases.

Original languageEnglish
Pages (from-to)309-320
Number of pages12
JournalAlzheimer Disease and Associated Disorders
Volume22
Issue number4
DOIs
Publication statusPublished - Oct 2008

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Keywords

  • Added diagnostic value
  • Dementia
  • Diagnostic protocol
  • Memory clinic
  • Neuropsychologic tests
  • Structural neuroimaging

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Gerontology
  • Clinical Psychology

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