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Neurology - Alzheimers

Houston, Texas

The Cullen Building at Baylor College of Medicine.
Department of Neurology
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What to Expect from Evaluation for Memory Loss

The Alzheimer's Disease and Memory Disorders Center evaluation is a four step process which typically takes place over the course of two weeks. First, the patient and their family will have an initial visit with the neurologist to discuss their concerns. At the first visit, the neurologist will review previous medical records, take a clinical history, and conduct an interview of the patient in the presence of the family. Family members will be asked to provide information about the problems that have been observed. Most patients also have blood drawn at the conclusion of this visit. Some patients also choose to have their chest x-ray done at this time. Next (step two), patients of the ADMDC are sent for imaging of the brain (i.e., CT, MRI, and/or PET), an electrocardiogram (i.e., heart monitoring to determine if the patient has had a heart attack or is experiencing abnormal heart function), and comprehensive neuropsychological testing. Your neurologist will determine which type of imaging test(s) is needed. Because the neuropsychological testing process takes an average of 4-6 hours, not including breaks for lunch, etc., this part of the evaluation occurs on a separate day following the initial visit.

All diagnostic tests must be completed before the patient and family return for the follow up visit. At the follow up visit (step three), the patient and family meet with the neurologist to discuss the results of testing. A diagnosis will be made, and options for treatment will be discussed. Information on clinical trials or drug studies may also be provided. If it is determined that the patient requires additional testing or a referral to another provider, this will be arranged. Lastly (step four), the patient and family meet with a psychologist who will assess the patient's current living situation and provide counseling on issues relevant to the management of the patient's condition. The counseling visit takes place immediately after the follow up visit with the neurologist (see the section on Patient Care for more information on counseling).

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% accuracy when a complete work up 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.

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. An evaluation will provide a diagnosis, which will in turn determine what course of treatment to take.

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