Which diagnostic labs are important to include in the workup for dementia in older adults, in addition to a complete blood count (CBC)?

The inclusion of Thyroid-stimulating hormone (TSH) and a comprehensive metabolic panel (CMP) in the workup for dementia in older adults is of significant importance. This is primarily because both thyroid dysfunction and metabolic abnormalities can contribute to cognitive decline and mimic or exacerbate symptoms of dementia.

Thyroid hormones play a critical role in brain function, and hypothyroidism, in particular, can lead to cognitive impairment, depression, and other neurological symptoms. Therefore, assessing TSH levels is essential to rule out thyroid-related causes of cognitive dysfunction.

The comprehensive metabolic panel provides a broad view of an individual’s metabolic health, including electrolyte balance, kidney function, liver function, and glucose levels. Abnormalities in these areas can lead to cognitive issues; for instance, renal impairment can cause a buildup of toxins that affect brain function, while abnormalities in glucose levels can affect cognition, particularly in individuals with diabetes.

By incorporating TSH and CMP in the lab workup, clinicians can identify treatable causes of cognitive decline that could potentially reverse or improve the patient's condition, thereby emphasizing the importance of these tests in the differential diagnosis of dementia.