A comprehensive neurological evaluation performed with cognitive tests, brain imaging, and biomarker tests when needed to determine the type of dementia in patients with memory and daily function loss.
Indication
- Recent memory loss; forgetting names and events
- Time-place confusion and difficulty with orientation
- Decreased independence in daily tasks (banking, medications, cooking)
- Personality and behavior changes
- Difficulty with speech and word finding
- Mild cognitive impairment (MCI) and its follow-up
- Differentiation between Alzheimer's, vascular, Lewy body, and frontotemporal dementia
Preparation
- Coming with a relative (important for information verification)
- Current medication list and previous test results
- Notes on the timing of symptom onset and progression
- Bring vision and hearing aids and have them in use during the visit
How it's performed
- Detailed neurological examination and patient/caregiver history
- Cognitive screening tests such as MMSE and MoCA
- Blood tests for treatable causes (B12, thyroid, metabolic)
- Structural assessment with brain MRI or CT
- In selected cases, amyloid PET or CSF tau/amyloid biomarkers
- Comprehensive neuropsychological test battery when needed
Post-procedure
- Cognitive and functional follow-up every 6 months
- Management of cholinesterase inhibitors (donepezil, rivastigmine) and memantine
- Management of behavioral and psychological symptoms (BPSD)
- Caregiver education and referral to support groups
- Discussion of driving, legal matters, and safety issues
Risks
- Delay in diagnosis or missing treatable causes
- Side effects of cholinesterase inhibitors such as nausea, diarrhea, and bradycardia
- Falls and cardiovascular risks with antipsychotic use
- Caregiver burnout and depression
- Progressive nature of the disease (currently no curative treatment)
FAQ
I am forgetful, do I have dementia?
Mild forgetfulness related to age is common. Forgetfulness that affects daily life, worsens, or is accompanied by time-place confusion should be evaluated.
Can Alzheimer's be treated?
There is currently no curative treatment; however, medications and cognitive/social activities may slow the progression of symptoms and improve quality of life.
Are amyloid PET or CSF tests necessary for everyone?
No. They are performed at the physician's discretion in selected cases such as early-onset, atypical, or diagnostically uncertain presentations.
How can I prevent dementia?
Control of blood pressure, diabetes, and cholesterol; smoking cessation; regular exercise, social interaction, and mental activity may reduce the risk.
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