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Thursday, October 6, 2011

The Diagnosis of Dementia Type Syndromes. What are the steps to follow?


The full article here is on courtesy of Carol Larkin, for use in this discussion forum only. Any other use would be on request of her agreement only. 

"A “fully baked” diagnosis has 3 parts."

By Carole B. Larkin 
Alzheimer's Reading Room


"One of my most common questions I get asked has to do with diagnosis of dementia. How does dementia get diagnosed?

My answer is:

Dementia isn’t a disease at all, in spite of how it is used in everyday language. Dementia is actually a description of symptoms of over 70 diseases. 

Symptoms such as confusion, memory loss, and changes in the personality of a person indicate that someone may have one of the diseases.

Different diseases may show different symptoms in varying strengths and at varying times. For example,Alzheimer’s disease, by far the most common of these diseases, estimated at upwards of 65% of all dementias, usually shows short term memory loss as its first and primary symptom.

Lewy Body disease, a lesser known but still significant dementia, shows balance problems and hallucinations earlier in its disease than does Alzheimer’s disease.

Vascular dementia, which comes from strokes and mini-strokes, shows varying symptoms depending on where in the brain the stroke occurred. Sometimes there is memory loss, sometimes not.

Frontal Temporal dementia usually presents as changes in personality and lack of inhibition rather than memory issues early in the disease.

Those are what I call “the big 4” diseases of dementia. There are plenty of others, minor players in terms of numbers of people who have a dementia.

Some diseases of dementia are “treatable”. Dementias that come from things like B-12 deficiency, thyroid imbalances, and NPH (Normal Pressure Hydrocephalus) can be treated.

The “big 4” are progressive and eventually terminal. There is no medicine at this time to “curethem but researchers worldwide are working hard to find an effective treatment or cure.

If a loved one shows one or more signs of dementia, they need to get what I call a “fully baked” diagnosis. 

A “fully baked” diagnosis has 3 parts.

Verbal and written tests and a complete history of medical and cognitive symptoms told to the doctor by the caregiver/family member,

An MRI and/or PET scan of the brain which may show if strokes or mini strokes have taken place,

Special blood tests to rule out other reasons for a dementia such as thyroid imbalance, B-12 deficiency, etc….

A “half baked” diagnosis is a 10-15 minute verbal or written test, then the doctor saying, “Here is a prescription for Aricept (or Exelon, or Namenda). Take this. I can’t do anything else for you.”

Don’t accept this treatment. Your loved one deserves more. Ask for all 3 parts of the diagnosis

What if your loved one has a treatable dementia? "


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