Diagnosis of Alzheimer's disease in Brazil: Supplementary exams

Paulo Caramelli, Antonio Lúcio Teixeira, Carlos Alberto Buchpiguel, Hae Won Lee, José Antônio Livramento, Liana Lisboa Fernandez, Renato Anghinah

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

This article presents a review of the recommendations on supplementary exams employed for the clinical diagnosis of Alzheimer's disease (AD) in Brazil published in 2005. A systematic assessment of the consensus reached in other countries, and of articles on AD diagnosis in Brazil available on the PUBMED and LILACS medical databases, was carried out. Recommended laboratory exams included complete blood count, serum creatinine, thyroid stimulating hormone (TSH), albumin, hepatic enzymes, Vitamin B12, folic acid, calcium, serological reactions for syphilis and serology for HIV in patients aged younger than 60 years with atypical clinical signs or suggestive symptoms. Structural neuroimaging, computed tomography or - preferably - magnetic resonance exams, are indicated for diagnostic investigation of dementia syndrome to rule out secondary etiologies. Functional neuroimaging exams (SPECT and PET), when available, increase diagnostic reliability and assist in the differential diagnosis of other types of dementia. The cerebrospinal fluid exam is indicated in cases of pre-senile onset dementia with atypical clinical presentation or course, for communicant hydrocephaly, and suspected inflammatory, infectious or prion disease of the central nervous system. Routine electroencephalograms aid the differential diagnosis of dementia syndrome with other conditions which impair cognitive functioning. Genotyping of apolipoprotein E or other susceptibility polymorphisms is not recommended for diagnostic purposes or for assessing the risk of developing the disease. Biomarkers related to the molecular alterations in AD are largely limited to use exclusively in research protocols, but when available can contribute to improving the accuracy of diagnosis of the disease.

Original languageEnglish (US)
Pages (from-to)167-177
Number of pages11
JournalDementia e Neuropsychologia
Volume5
Issue number3
DOIs
StatePublished - Sep 2011
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Brazil
  • Consensus
  • Diagnosis
  • Guidelines
  • Supplementary exams

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cognitive Neuroscience

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