A-032 The Relative Contribution of Neuropsychological Assessment and Radiological Scans to Diagnostic Accuracy in Young Onset Dementia

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Abstract Objective Younger-onset dementias (YOD) are relatively rare neurodegenerative disorders that often present unique diagnostic challenges to health professionals. These difficulties often result in significant delays to diagnosis and uncertainty in clarifying the aetiology of a client’s presenting problems. In this audit of routine clinical practice, we evaluate the utility of radiological scan reports (Magnetic Resonance Imaging (MRI), Single Photo Emission Computed Tomography (SPECT) and Computerised Tomography (CT) with neuropsychological assessment, and retrospectively evaluate the relative contribution of each approach to diagnostic accuracy. Method 83 clinical records were reviewed from a regional specialist centre for assessment and diagnosis of YOD in the United Kingdom. Patients were assessed using clinical interview, neuropsychological assessment and neuroradiological diagnosis (MRI, SPECT or CT scan). The correlations between radiologist report, neuropsychological status and neuropsychiatric evaluation were compared to established diagnoses retrospectively. Results The diagnostic labels identified and highlighted in radiology reports were found to be congruent with the final agreed diagnosis, arrived as a consensus by a multidisciplinary team of clinicians, in 70% of cases. In contrast, neuropsychological opinion was congruent with the final agreed clinical diagnosis in 93% of cases. Substantial differences in congruency between scan report and clinical diagnosis were observed for the different neuroradiological techniques with SPECT showing high rates of false positive abnormality. Conclusion Overall, neuropsychological opinion concurred with final diagnostic outcomes significantly more frequently than diagnosis indicated by radiology scan report. Results are discussed in terms of both cost–benefit analysis and the clinical utility of both assessments in the diagnosis of YOD.