Evaluation and Diagnostics
An evaluation will determine if the changes in thinking or memory being observed are due to normal aging or the presence of disease. An evaluation will determine if the cause of the problem is progressive and likely to worsen over time, or if the changes are due to a previously undetected event which may never occur again.
We adhere to nationally recognized standardized diagnostic criteria to establish a diagnosis and determine the severity of the condition. An evaluation will determine if the changes in thinking or memory being observed are due to normal aging or the presence of disease or if the cause of the problem is progressive and likely to worsen over time. The evaluation also determines whether there are other medical conditions or secondary, non-cognitive features (e.g., behavioral changes, anxiety, agitation, sleep disturbance, agitation) contributing to the memory/thinking problems.
Persons seeking evaluation for memory or thinking difficulties are given a full battery of diagnostic tests, including:
- Lab studies
- Neuro-imaging
- Neuropsychological evaluation
- Neurological evaluation
The evaluation is a four-step process which typically takes place over the course of two weeks. The goal of the evaluation is to provide a diagnosis which will, in turn, determine what course of treatment to take.
Diagnostic Limitations for Alzheimer's Disease
While it is true that the presence of Alzheimer's disease can only be confirmed through autopsy or brain biopsy, a diagnosis can be made with greater than 90 percent accuracy when a complete workup is done, and nationally recognized, standardized diagnostic criteria are applied. It is important to realize there is no single lab test for AD. Similarly, having a brain scan alone will not determine if someone has AD because there may be no visible changes in the brain early on in the course of the disease, or the brain may show normal age-related changes or changes due to the presence of another type of dementia. A brain scan will tell your neurologist if the patient has had an injury or neurological event such as a stroke, but it cannot rule out the presence of Alzheimer's disease.
Monitoring, Treatment and Care
Our patients and family members receive the support of a multidisciplinary team over the course of their illness. Similar to diabetes or heart disease, Alzheimer's disease and other progressive dementias are chronic health conditions which require periodic reassessment and routine monitoring to ensure proper treatment.
Our patients are seen at least yearly for a complete checkup, including a full neuropsychological assessment to determine their response to treatment and degree of stabilization or progression.
Because we follow our patients closely and for such a long period of time, we are able to address the changing needs of both the patient and those who care for him.
Drug Therapy/Medications
There are numerous causes of memory and thinking difficulties. Many, including Alzheimer's disease, are treatable. Others, such as depression, thyroid problems, severe nutritional deficiency, or medication interaction, may be reversible. Patients who are evaluated through the ADMDC should expect to have their options for treatment identified and explained to them so that they may make a well informed decision about their care. If a diagnosis of AD is made, regardless of the severity of the disease, treatment options are available.
FDA approved medications for Alzheimer's disease are not a cure and are not expected to improve a person's functioning, although this may occur for some time in some cases. Rather, medications for Alzheimer's disease are intended to stabilize cognitive and functional abilities from the point the medication is started.
Medical Counseling
We believe counseling about cognitive disorders plays a fundamental role in the care of persons with dementia. Consequently, we build this component into our care plan for all of our patients and families.
Medical counseling should not be confused with therapy. Counseling within the setting of the ADMDC is intended to educate the patient and family about their condition, determine factors influencing the immediate and long-term management of the disease, and assist in developing a treatment plan.
