Investigation

All patients require a full medical history and physical examination. Treatable causes (such as brain tumour, subdural haematoma, normal pressure hydrocephalus, infections, hypothyroidism, or vitamin B12 deficiency) may be revealed by investigations such as blood count and ESR, urea and electrolytes, liver function tests, thyroid function tests, B12 and folate, calcium and phosphate, serological tests for syphilis, HIV antibody testing (with informed consent), chest radiography, EEG, and brain scan.

Potentially treatable factors can be identified in many dementia patients, but good results from treatment are obtained in few. Expensive or invasive investigations are only indicated if their results would alter management, and are seldom justified in patients whose dementia is very severe or whose general physical state is very poor.

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