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 3 1 % 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.