Frequency of dementia syndromes with a potentially treatable cause in geriatric in-patients: analysis of a 1-year interval

Abstract

In addition to neurodegenerative and vascular causes of dementia, in the differential diagnosis potentially reversible conditions of dementia also must be assessed. Routine laboratory parameters and neuroimaging, which are recommended for the differential diagnosis of suspected dementia by the German S3 Guideline "Dementia", were retrospectively studied in 166 geriatric patients with suspected dementia. Delirium was diagnosed in six patients (3.6 %). These six patients were excluded from the study. Of the 160 remaining patients, there were 99 (59.6 %) with an already known dementia. In this subgroup of patients, we found a potentially treatable cause of dementia in 18.2 %. In the remaining 61 patients (36.8 %), the newly diagnosed dementia syndrome was established according to ICD-10 criteria. Potentially reversible causes of the dementia syndrome were found in 19 of these patients (31.1 %). The most common cause was depressive pseudodementia in eight patients followed by vitamin B-12 deficiency in six patients. A significant amount of our patients showed laboratory or imaging changes suggestive of potentially reversible causes of the dementia syndrome upon admission. The results of our study indicate the importance of careful differential diagnosis of dementia based on the recommendations of guidelines. Although therapy of these potential causes is not always accompanied by a full recovery, the identification and therapy of treatable causes of cognitive deficits are possible even for general practitioners, who often are the primary contact persons of affected individuals.