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 Medical Self-Care: Early Alzheimer's Disease: Recognition and Assessment. - Guideline Overview No. 19 
 

  • Patients who have abnormal results on only the mental status test require more complete testing. Results that indicate possible neuropsychiatric or systemic neurological problems call for referral to an appropriate specialist.
  • Patients who have declining function but normal mental status test results require either (1) further neurological evaluation for systemic neurological diseases or (2) psychiatric or psychological evaluation if evidence suggests depression or other emotional problems.
The Role of Neuropsychological Testing
Neuropsychological tests can examine performance across different domains of cognition. This broad battery of tests can help in identifying dementia among persons with high premorbid intellectual functioning, discriminating patients with a dementing illness from those with focal cerebral disease, and differentiating among certain causes of dementia.

The Importance of Followup
Followup, with assessment of declining mental function, may be the most useful diagnostic procedure for differentiating Alzheimer's disease from normal aging. For this reason, the mental status test should be repeated over a period of 6 to 12 months. In cases of referral, it is important to make sure that test results and medical records follow the patient from the specialist back to the referring clinician.

Key Points About Alzheimer's Disease

Key Points About Alzheimer's Disease

  • Although changes in memory or cognition may accompany normal aging, significant impairment and disability are not a part of normal aging.
  • It is important for clinicians, as well as patients and family members, to recognize symptoms that should trigger an initial assessment for dementia.
  • Some causes of dementia can be treated effectively to eliminate or greatly improve cognitive performance.
  • Among older persons, depression and interactions from multiple medications are two common and highly treatable causes of dementia symptoms.
  • An initial assessment for dementia can (1) lead to effective treatment of causes; (2) prevent unnecessary and possibly harmful treatment resulting from misdiagnosis; and (3) avoid the trauma of a diagnosis of dementia or Alzheimer's disease where it does not exist.
  • The prolonged course of deterioration found in many dementias takes a major emotional, psychiatric, and physical toll among family members and caregivers.
  • Learn more about symptoms that may indicate early-stage dementia and how to conduct an initial assessment. Read Recognition and Initial Assessment of Alzheimer's Disease and Related Dementias, Clinical Practice Guideline No. 19, and use its companion Quick Reference Guide for Clinicians. Give the Consumer Version to patients, family members, and other caregivers.

For Patients

  • Dementia is different from normal aging. Only certain tests can show that difference. Symptoms that suggest Alzheimer's disease or a related dementia should be brought to the attention of the family's health care provider as soon as possible.
  • Some memory and other problems can improve or disappear with appropriate treatment.
  • Although there is not yet a clearly effective treatment for Alzheimer's disease, resources are available to help patients and families cope with this condition and prepare for the future.
  • Order the consumer booklet, Early Alzheimer's Disease: from the U.S. Government's Agency for Health Care Policy and Research. It provides information about the early stages of Alzheimer's disease and similar illnesses. It also includes a list of resources where readers can find out more about the medical, financial, and social support services that are available in their communities.
  • The Agency for Health Care Policy and Research also has a Clinical Practice Guideline and a Quick Reference Guide for health care providers about early identification of Alzheimer's disease and other forms of dementia.
Symptoms That Might Indicate Dementia
Does the person have increased difficulty with any of the activities listed below? Positive findings in any of these areas generally indicate the need for further assessment for the presence of dementia.
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