When should I consider referring a patient with suspected frontotemporal dementia to a specialist for further evaluation?

Consider referring a patient with suspected frontotemporal dementia (FTD) to a specialist dementia diagnostic service (such as a memory clinic or community old age psychiatry service) after reversible causes of cognitive decline have been investigated and dementia is still suspected. These reversible causes include delirium, depression, sensory impairment, or cognitive impairment from medicines with anticholinergic burden.

If frontotemporal dementia is suspected and the diagnosis remains uncertain after initial assessment, further specialist evaluation using FDG-PET or perfusion SPECT imaging may be considered to assist diagnosis.

Referral to specialists with expertise in dementia diagnosis is important to confirm the subtype of dementia, including FTD, and to ensure appropriate post-diagnostic support and management.