- 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.
The Role of Neuropsychological Testing
- 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.
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
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
- Some causes of dementia can be treated effectively to
eliminate or greatly improve
- 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
- The prolonged course of deterioration found in many
dementias takes a major emotional,
psychiatric, and physical toll among family members and
- 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.
- 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
- 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
- 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.
Symptoms That Might Indicate Dementia
- 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.
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