The growing need for lumbar puncture in order to obtain cerebrospinal fluid (CSF) for the diagnosis Alzheimer's disease is becoming increasingly apparent (Herskovits and Growdon, 2010). The concept of a CSF sampling unit specializing in lumbar puncture would seem the most plausible solution. Physicians and interns are not necessarily skilled in the procedure and neurologists perform lumbar puncture rarely.

A recent study reported the relationship between suicide rates in both sexes in the age bands 65–74 and 75+ years and the Gross National Domestic Product (GDP), a measure of socio-economic status, as being curvilinear (inverted U-shaped curve) and fitting the quadratic equation y = a + bx−cx2 (where y is the suicide rate, x is the Gini coefficient and a, b and c are constants) (Shah, 2010). This relationship was explained using the epidemiological transition hypothesis (Shah and Bhat, 2010) and the explanatory model included the following sequence of events (Shah, 2010): (i) countries with low socio-economic status have poorly developed healthcare system; (ii) a poorly developed healthcare system is associated with increased child mortality; (iii) increased child mortality rates result in reduced life expectancy; and (iv) reduced life expectancy leads to fewer people reaching old age, the age at which the risk of suicide is high. In order to provide support for this hypothesis other data sources related to socio-economic status, quality and quantity of healthcare services and life expectancy were examined.

Alzheimer's disease (AD) manifests clinically with an insidious onset and slow but progressive cognitive impairment. The clinical picture of AD can be classified into cognitive and behavioral changes. The initial deficit usually manifests as an amnesic syndrome which may progress very gradually for several years before impairment in other cognitive domains, such as language, semantic memory and visuospatial function, becomes apparent (Hodges and Patterson, 1995).