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The use of a structural
neuroimaging study, such as a computerized tomography (CT) or a
magnetic resonance imaging (MRI) scan, is generally recommended
as part of an initial evaluation, particularly for patients with
a subacute onset (less than 1 year), age at onset less than 65 years,
vascular risk factors, or possible focal lesion. The value of imaging
in patients with late-stage disease who have not been previously
evaluated has not been established. Functional neuroimaging using
positron emission tomography (PET) may contribute to diagnostic
specificity (e.g., to differentiate Alzheimer's disease
and frontotemporal dementia).
Neuropsychological testing may be helpful to differentiate among
dementias, evaluate a patient with subtle or atypical symptoms,
characterize the extent of cognitive impairment, establish baseline
function, and guide treatment.