Diagnosis of irreversible dementia: how extensive the evaluation?

Recommendations for managing the patient with irreversible dementia can be organized according to the results of the initial evaluation. The patient may have normal mental status and normal functional assessment, abnormal mental status and abnormal functional assessment, or mixed results (one normal, one abnormal). The extent of further investigations usually depends on initial clinical findings and on patient and/or family preferences. MRI imaging may be useful prior to referral if greater specificity in diagnosis is desired. Referral is suggested for illnesses of short duration, atypical features, or when the patient and family require precision in diagnostic labeling.