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The DMSS-4 allows for rapid assessment of clinical subtypes in delirium and has high concordance with the longer and well-validated DMSS. More consistent clinical subtyping in delirium can facilitate better delirium management and more focused research effort.

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Background and Aim: Data showing the usefulness of MRI to improve the accuracy of the diagnostic process in cognitive disorders were derived from studies in tertiary referral centers. MRI is widely used as a diagnostic tool in everyday practice, but it is unknown what the actual added value of MRI is. We studied the usefulness of MRI in the diagnostic process by measuring the change of confidence of the physician. Methods: Physicians indicated confidence in their diagnosis before and after presentation of MR images using a visual analogue scale from 0-100%. Results: Use of MRI increased the level of confidence by 3% in experienced clinicians and by 9% in inexperienced physicians. In 2/125 cases, MRI showed an unexpected finding. Conclusion: MRI is a useful diagnostic tool in everyday practice of diagnosing cognitive disorders.

Background: In the Netherlands, dementia syndromes are diagnosed in specialized memory outpatient clinics (MC). Many radiologists are not trained to assess magnetic resonance imaging (MRI) scans with respect to possible radiological changes that may indicate neurodegenerative disease. Methods: This is a cross-sectional descriptive study. A survey was sent to all Dutch MC and included questions as to how MRI scans are assessed by radiologists and how these assessments are used in the diagnostic process. Results: In most MC, radiologists report on typical Alzheimer pathology and large vessel disease. Small vessel disease and other anatomical changes signifying neurodegenerative disease frequently are not assessed. In the majority of MC, the radiological assessment is not standardized, and physicians assess MRI for themselves to use this information to discuss the consensus diagnosis subsequently. Conclusion: MRI assessment by radiologists in Dutch MC probably underestimates the presence of cerebrovascular and neurodegenerative disease. The validity of standardized assessment protocols in routine clinical practice deserves further study, as the implementation of standardization outside research settings could improve diagnostic accuracy.