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Cases may be missed in the elderly population where dementia is common with less frequent referral to specialist neurological services. This study\u2019s twin aims were to determine the feasibility of a method to detect possible missed cases in the elderly population and to identify any such cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A multi-site study was set-up in Lothian in 2016, to determine the feasibility of enhanced CJD-surveillance in the 65\u2009+\u2009population-group, and undertake a clinicopathological investigation of patients with features of \u2018atypical\u2019 dementia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Thirty patients are included; 63% male, 37% female. They were referred because of at least one neurological feature regarded as \u2018atypical\u2019 (for the common dementing illnesses): cerebellar ataxia, rapid progression, or somato-sensory features. Mean-age at symptom-onset (66\u00a0years, range 53\u201382\u00a0years), the time between onset-of-symptoms and referral to the study (7\u00a0years, range 1\u201313\u00a0years), and duration-of-illness from onset-of-symptoms until death or the censor-date (9.5\u00a0years, range 1.1\u201317.4\u00a0years) were determined. By the censor-date, 9 cases were alive and 21 had died. Neuropathological investigations were performed on 10 cases, confirming: Alzheimer\u2019s disease only (2 cases), mixed Alzheimer\u2019s disease with Lewy bodies (2 cases), mixed Alzheimer\u2019s disease with amyloid angiopathy (1 case), moderate non-amyloid small vessel angiopathy (1 case), a non-specific neurodegenerative disorder (1 case), Parkinson's disease with Lewy body dementia (1 case), and Lewy body dementia (2 cases). No prion disease cases of any type were detected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The surveillance approach used was well received by the local clinicians and patients, though there were challenges in recruiting sufficient cases; far fewer than expected were identified, referred, and recruited. Further research is required to determine how such difficulties might be overcome. No missed cases of vCJD were found. However, there remains uncertainty whether this is because missed cases are very uncommon or because the study had insufficient power to detect them.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-022-03280-4","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T15:03:42Z","timestamp":1658329422000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A clinicopathological study of selected cognitive impairment cases in Lothian, Scotland: enhanced CJD surveillance in the 65\u2009+\u2009population group"],"prefix":"10.1186","volume":"22","author":[{"given":"Lovney","family":"Kanguru","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Logan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Briony","family":"Waddel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Molesworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Knight","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"3280_CR1","first-page":"6","volume":"23","author":"PJ Urwin","year":"2017","unstructured":"Urwin PJ, Thanigaikumar K, Ironside JW, Molesworth A, Knight RS, Hewitt PE, Llewelyn C, Mackenzie J, Will RG. 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