Nonmedical complications of diagnostic workup for dementia [clinic conference]

Testing for patients presenting with dementias can lead to diagnosis of disorders that can contribute to cognitive dysfunction, and to improvement, stabilization, or slowed deterioration in some demented patients. However, possible benefits must be balanced against possible costs. The present recommendations for workup of patients with dementia includes some tests with only marginal benefits, and a more limited workup may be as effective. This case demonstrates how important it is to be sensitive as well to possible effects on family relationships of demented patients. When we evaluate and treat demented patients, the dependence of the demented patient on the caregiver and the emotional and physical stresses experienced by many caregivers make it important to consider the patient and caregiver as a system vulnerable to many potential risks.