Scottish Intercollegiate Guidelines Network Guidance on Dementia: The Investigation of Suspected Dementia (SIGN 168) with Focus on Biomarkers—Executive Summary

Graham Andrew Mackay; Claire Gall; Ravi Jampana; Carolyn Sleith; Gregory Y. H. Lip; on behalf of the SIGN Dementia Guideline Development Group

doi:10.1055/a-2332-6426

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2025; 125(01): 012-020
DOI: 10.1055/a-2332-6426

Review Article

Scottish Intercollegiate Guidelines Network Guidance on Dementia: The Investigation of Suspected Dementia (SIGN 168) with Focus on Biomarkers—Executive Summary

Graham Andrew Mackay

¹Department of Neurology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom

,

Claire Gall

²Department of Neurology, Queen Elizabeth University Hospital, Glasgow, United Kingdom

,

Ravi Jampana

³Department of Neuroradiology, Queen Elizabeth University Hospital, Glasgow, United Kingdom

,

Carolyn Sleith

⁴Healthcare Improvement Scotland, Edinburgh, United Kingdom

,

Gregory Y. H. Lip

⁵Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom

⁶Department of Clinical Medicine, Danish Center for Health Services Research, Aalborg University, Aalborg, Denmark

,

on behalf of the SIGN Dementia Guideline Development Group

› Institutsangaben

Abstract

This is an executive summary of the recent guidance produced by the Scottish Intercollegiate Guidelines Network (SIGN) dementia guideline group with regards to the investigation of suspected dementia. This is a sub-section of the broader SIGN 168 guideline released in November 2023. The guideline group included clinicians with expertise in Old Age Psychiatry, Neurology, Radiology, and Nuclear Medicine supported by colleagues from the SIGN and Healthcare Improvement Scotland teams. There was representation from carers and support organizations with experience of dementia, to ensure the recommendations were appropriate from the perspective of the people being assessed for possible dementia and their carers. As the 2018 National Institute for Health and Clinical Excellence (NICE) dementia review included a review of the evidenced investigation of dementia, the SIGN guideline development group decided to focus on a review on the up-to-date evidence regarding the role of imaging and fluid biomarkers in the diagnosis of dementia. To give context to the consideration of more advanced diagnostic biomarker investigations, the guideline and this summary include the NICE guidance on the use of standard investigations as well as more specialist investigations. The evidence review supports consideration of the use of structural imaging, nuclear medicine imaging, and established Alzheimer's cerebrospinal fluid biomarkers (amyloid and tau) in the diagnosis of dementia. Although routine use of amyloid positron emission tomography imaging was not recommended, its potential use, under specialist direction, in patients with atypical or young-onset presentations of suspected Alzheimer's dementia was included as a clinical good practice point.

Keywords

dementia - guideline - investigation - biomarker

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Referenzen

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