If you or a loved one is having problems with your memory or other thinking skills (cognitive skills), Alzheimer’s and brain health specialists at California Pacific Medical Center can help you determine the cause of the problem. Alzheimer's disease and other types of dementia are defined as a loss of memory and other mental abilities severe enough to interfere with normal daily activities.
Alzheimer's disease is the most common type of dementia, but it's not the only cause of cognitive impairment. There are many other types of neurodegenerative dementia. A number of underlying medical issues can cause significant cognitive change, but they may be treatable. Getting an accurate diagnosis is the first step.
The Diagnostic Process
Clinicians use a wide variety of tests, including cognitive assessment, brain imaging and blood lab work, to help determine if a person has Alzheimer's disease or a related disorder, or whether their condition may be the result of a treatable medical condition. Our brain health specialists begin with a thorough history and review of your situation. They then use a wide range of tools to assess cognitive functioning and rule out problems that may be mistaken for a neurodegenerative condition, such as hearing loss or depression. They will also assess for medical issues, such as diabetes or high blood pressure, which can cause vascular changes in the brain and contribute to cognitive changes.
Laboratory tests on blood and urine samples can help to identify or rule out other conditions that can cause cognitive problems and that sometimes look like Alzheimer’s disease. Brain imaging is also essential early on as part of a thorough diagnosis.
A neurological examination helps determine how well your nervous system is functioning. A doctor will carefully assess your personal history and perform a cognitive screen. The neurological examination assesses speech, strength, sensation, balance, coordination and movement. This involves fairly simple tasks such as moving your eyes, pulling or pushing the doctor's hand or walking a straight line.
A neuropsychological evaluation usually occurs over the course of several hours. A doctoral level psychologist who has received special training in neuropsychology and the understanding of brain-behavior relationships starts with a detailed interview with you and, ideally, a loved one or confidant. The psychologist will ask you questions about your current cognitive concerns, daily functioning and activities, emotional well-being, and medical, family, educational, and work history. This helps your doctor understand more about your particular circumstances.
The second step involves neuropsychological tests to evaluate how your brain’s health is affecting your behavior, your ability to carry out daily living tasks, and your ability to think, remember, solve problems, learn and reason. Most of these tests involve tasks such as remembering a list of items, drawing pictures, sorting items and naming objects in pictures. Using all of the gathered information, the neuropsychologist can assist with diagnosis, assess your strengths and weaknesses, determine areas of change, and make recommendations to help you in your daily life.
Imaging Exams and Neurodiagnostics
Imaging scans of the brain can help your doctor diagnose some causes of cognitive impairment, such as a tumor, stroke, a neuro-degenerative process and head trauma. An MRI scan is usually the first choice of exam; other options are CT and PET scans.
Additional tests may include:
- Laboratory evaluations such as blood work.
- A sleep evaluation to identify problems such as sleep apnea or breathing problems that can affect cognitive function.
- A nutritional assessment that helps your doctor make adjustments to your diet that might boost your energy, improve strength, or lower your blood sugar, cholesterol or blood pressure levels.