Neurological disorders and memory loss are very complex, and comprehensive evaluations are necessary to determine an accurate diagnosis. Physical and neurological examinations should focus on ruling out any medical illnesses other than dementia that could cause cognitive decline.
Lab tests can assist in determining whether a treatable condition may be contributing to changes in thinking or memory. Some of these blood tests include a complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, rapid plasma reagin and human immunodeficiency virus.
Structural scans such as magnetic resonance imaging or computed tomography also are used in testings. The MRI is useful in that it produces images of the inside of the body or head. The CT scan produces cross-sectional images of the inside of the body or head and is similar to the MRI, however, it does not image the brain structure with the exactness of the MRI.
A SPECT scan shows how blood flows through the arteries in the brain. The scanner computes brain activity after a radioactive material, called a tracer, is injected in the arm. Brain areas affected by disease typically show diminished activity.
Another functional scan, the fMRI, can show blood flow in the brain. Additionally, the PET scan shows activity of tissues measuring the metabolic activity of the brain, which helps the physician determine which areas of the brain are healthy. Amyloid imaging with the PET scan can distinguish if the individual has a buildup of the amyloid protein, a sign of Alzhiemer's disease.
Neuropsychology testing complements clinical assessments of the individual and can evaluate behavior, language, visuospatial abilities, memory, abstraction, mental control, motor skills and intelligence. Such evaluations include an electroencephalogram, which show patterns of electrical activity in the brain, or a cerebrospinal fluid exam, which can rule out or investigate the possibility of various conditions. Though the MRI and PET scans are better at identifying disease biomarkers, the CSF testing may indicate rapid injury to nerve cells in the brain.
With thorough assessments, lab and scan evaluations, physicians can determine the type of neurogenerative disease. Other issues should be ruled out before a diagnosis, however. These include reactions to medications, nutritional deficiencies, emotional and/or psychiatric problems, infections or metabolic abnormalities.
Questions about Alzheimer's disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer's Services of the Capital Area at firstname.lastname@example.org or visit the organization at 3772 North Blvd., Baton Rouge.