Possible Early Dementia (cont.)
Rodrigo O Kuljis, MD
Nestor Galvez-Jimenez, MD
Francisco Talavera, PharmD, PhD
Helmi L Lutsep, MD
IN THIS ARTICLE
Exams and Tests
Pinpointing the cause of memory loss is a challenge to your health care provider. Alzheimer's disease and many other causes of dementia cannot be diagnosed with certainty by lab tests or brain scans. Your health care provider will ask you many questions about your symptoms and how they started, your other medical problems, your family’s medical problems, your medications, your habits and lifestyle, and your work and travel history.
The medical interview is followed by a careful physical examination and, possibly, lab tests and scans. Cognitive processes are tested by how well you answer certain questions and follow simple directions. Part of the process of making the diagnosis is ruling out conditions that do not fit the facts. At any time in this process, your health care provider may refer you to a specialist in diseases of elderly persons (gerontologist) or in diseases of the brain (neurologist or psychiatrist).
No specific laboratory test confirms the diagnosis of MCI. Most tests are done to rule out reversible conditions such as thyroid disorders, chemical imbalances, vitamin deficiencies, and infections.
CT scan and MRI are used to "see" the brain and surrounding organs. Like lab tests, these brain scans do not give a definitive diagnosis of MCI. They may show abnormalities in the brain that are consistent with Alzheimer's-like dementia. They also are used to rule out potentially reversible causes of MCI.
Neuropsychological testing is the most accurate method of pinpointing and measuring a person’s cognitive problems and strengths. Neuropsychological testing is very useful in diagnosing MCI.
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Perhaps the most important challenge in treating dementia is identifying cases (albeit uncommon) of reversible dementia such as chronic drug intoxication, vitamin deficiencies (B-12 and folate), subdural hematoma(s), major depression (causing forgetfulness), normal pressure hydrocephalus (NPH), and hypothyroidism.