Social Worker Darby Morhardt describes what a detailed Alzheimer's disease evaluation includes.
Typically, a good evaluation is going to entail going to a neurologist for a good physical, neurological examination. They are also going to want to hear what has changed over time.
I mean, all of us, as we age, have changes in our memory and our thinking, but what has changed to the point that you are having trouble managing independently, and they are going to want to hear that history of that change, not only from the person with the illness, but also from their family and/or people that are close to them.
Another, what they will also do is do a series of blood tests to rule out any metabolic disorders that may be causing changes in memory or thinking like vitamin B12 deficiency can cause changes in memory and thinking, or thyroid disorder can also cause. If you are depressed, you don’t think as well; you don’t concentrate as well. So that may mimic dementia symptoms.
So you want to get those, you want to get blood tests and evaluation to rule out other possible causes of the illness. So a good neurologist is going to get into all of that. They are also going to do a CAT scan or an MRI. It’s an imaging procedure to look at the brain and see whether or not there’s anything structural there that might be causing the changes in thinking and memory, behavior.
So that takes a while to do that, and usually a neurologist spends about an hour and a half for that initial visit. They will then also do some cognitive screenings, some memory testing. They’ll also test language, visual-spatial abilities, all the different cognitive domains to see how every part of the brain is functioning, and most often, they refer to a neuropsychologist for a good, detailed battery of tests to really look into even more depth into those problems.
A neuropsychologist, that’s a separate appointment. It’s another exam. It is usually about 2 to 3 hours; in some cases it can be even longer. We try to keep it as brief and succinct and focused as possible, and those tests then, combined with the neurological evaluation, can really help to pinpoint where the problems are, and along with that clinical history that the family has provided, it then can help the healthcare professional or clinician become almost about 90 to 95% certain of a diagnosis of Alzheimer’s disease or a related type of dementia.
About Darby Morhardt, M.S.W., L.C.S.W.:
Darby Morhardt is a research associate professor, the Director of Education, and a clinical research social worker at Northwestern University Feinberg School of Medicine. Her research interests include early stage and Younger Onset dementia programs and services, the dynamics and functioning of caregiving families, the subjective experience of Alzheimer's disease, and primary care physician education.