New patients will typically undergo a comprehensive work-up to understand if there are cognitive or memory problems, how severe they are, and what the underlying causes may be. Most initial work-ups consist of an initial neurological evaluation, a neuropsychological evaluation, and a MRI of the brain. In some cases, more advanced diagnostic imaging or lab work may be recommended to better identify the causes of the symptoms.
Initial Assessment Procedure
During the neurological evaluation, our neurologist will review your medical history, including any current or past illnesses and medications you are taking. He or she will also ask about key medical conditions affecting other family members, including whether they may have had Alzheimer’s disease or related dementias. In addition, our neurologist may test:
- Mental status
- Muscle tone and strength
- Eye movement
The neurological evaluation helps determine whether patients’ concerns and symptoms are due to normal age-related changes, common medical problems, or a neurological disorder. The evaluation can also be used as a tool to help differentiate among diseases. After the evaluation, our neurologist discusses the findings with the patient and his or her family and provides recommendations for further evaluation and/or treatment. In some cases, neuropsychological testing, brain imaging, and/or lab work may be recommended to better identify the causes of the symptoms.
Neuropsychological Assessment and Follow-up
A neuropsychological assessment includes a clinical interview with patients and family members to understand their concerns and problems. Our neuropsychologist first reviews the patient’s symptoms, medical history, medications, and other important factors. Patients then complete tests that assess many areas of thinking and memory. Test scores are compared to scores from healthy people who are similar in age and education. Using these methods, a pattern of cognitive strengths and weaknesses is identified. Testing can help determine whether memory concerns are due to normal age-related changes or if they reflect a neurological disorder. Testing can also be used as a tool to help differentiate among diseases. Following the evaluation, our neuropsychologist meets with the patient and his or her family to discuss the findings, provide recommendations pertinent to safety and day-to-day living, and answer any questions.
A standard medical workup for Alzheimer’s and related diseases often includes brain imaging with MRI or CT. In some cases, more advanced diagnostic imaging, such as a PET scan, may be recommended. Imaging can reveal different patterns of brain atrophy or functioning, as well as evidence of small or large strokes, tumors, or buildup of fluid in the brain that can help determine a diagnosis.
After patients complete their initial work-up (e.g., neurological assessment, neuropsychological evaluation, and brain imaging and lab work) they will be seen by our neurologist for a diagnostic follow-up visit. At this visit, our neurologist will review the results from the initial work-up and when possible, provide a diagnosis. They will also make treatment recommendations or if necessary, order additional tests.