Initial Laboratory Evaluation for Cognitive Impairment

Rationale for Diagnostic Testing

• EEG is not recommended for routine initial evaluation of dementia, and would be appropriate only if rapidly progressive dementia is suspected, seizure activity is suspected clinically, or Creutzfeldt-Jakob disease is being considered, as stated by the American College of Radiology 1
• Genetic markers including apolipoprotein E are not recommended for routine diagnostic purposes, as they do not establish or exclude Alzheimer's disease diagnosis, have no role in clinical management decisions, and are primarily a research tool, according to the American College of Radiology 1
• Occupational therapy referral for instrumental activities of daily living (IADL) assessment should not be done prematurely, before completing the basic medical workup, as stated by the Alzheimer's and Dementia journal 3
• The American College of Radiology recommends against the use of EEG for routine initial evaluation of dementia, except in cases of suspected rapidly progressive dementia, seizure activity, or Creutzfeldt-Jakob disease 2