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Updated: Feb 22, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
[Doctor, is my mother suffering from dementia?]
P Scheltens1, F Gillissen, F H Bouwman
1VU medisch centrum, afd. Neurologie en Alzheimercentrum, Amsterdam.
Abstract:
- The Netherlands health service features a stepwise diagnostic course in primary, secondary and tertiary care. In the diagnostic process for dementia the patient can go to the general practitioner, then to one of the 100 memory clinics and finally to one of the 4 academic Alzheimer centres.- The diagnostic process for dementia is described in the care practice guideline 'Dementia', the NHG (Dutch College of General Practitioners) practice guideline 'Dementia' and the multidisciplinary guideline 'Dementia diagnostics'.- Most patients will only have to follow part of this care chain before an adequate diagnosis is made and appropriate care can be implemented.- New validated instruments for dementia diagnostics have recently become available, including the Amsterdam instrumental activities of daily living (A-IADL) scale, biomarkers in cerebrospinal fluid (CSF) and the Medial temporal atrophy (MTA) scale for interpreting MRI scans.- The individual risk of dementia can be estimated using the MMSE score, MRI scans and the results of CSF investigations.
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