Diagnosing suspected Alzheimer’s disease | Right Decisions

Right Decisions
Assessment, diagnosis, care and support for people with dementia and their carers (SIGN)
Back
Further investigative procedures
Diagnosing suspected Alzheimer’s disease

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Recommended tests

If the diagnosis is uncertain and Alzheimer’s disease is suspected, consider either:

FDG-PET (fluorodeoxyglucose-positron emission tomography-CT), or perfusion SPECT (single-photon emission CT) if FDG-PET is unavailable

or

examining cerebrospinal fluid for:
- either total tau or total tau and phosphorylated-tau 181 and
- either amyloid beta 1–42 or amyloid beta 1–42 and amyloid beta 1–40.

If a diagnosis cannot be made after one of these tests, consider using the other one.

Routine use of amyloid PET in the diagnosis of dementia or mild cognitive impairment is not recommended.

Amyloid PET may be considered for improving the diagnosis of Alzheimer’s dementia in situations where there is still uncertainty following specialist assessment and structural brain imaging, for example in those with an atypical presentations or young-onset dementia.

Any consideration of amyloid PET should follow a full clinical assessment by a dementia specialist, and discussion of the potential risks from radiation.

Testing of established CSF biomarkers should be arranged by dementia specialists following clinical assessment. The risks and benefits of undertaking a lumbar puncture should be discussed with the individual, and any risks managed.