It is important for seniors who have - or who are suspected to have - Alzheimer’s disease to be evaluated by a neurologist. Memory loss is common, but it is not always Alzheimer’s disease. Many conditions can cause cognitive changes, identifying the correct cause matters because some conditions are treatable, and even when Alzheimer’s disease is confirmed, the treatment plan has changed significantly in recent years.
A neurological evaluation helps determine whether a person has normal aging, mild cognitive impairment, Alzheimer’s disease, or another neurological condition. The visit usually includes a detailed history from the patient and family, review of medications, screening for mood and sleep disorders, neurological examination, and cognitive testing. Brain imaging is also important tool during this process.
A modern memory evaluation also includes blood work to look for reversible or contributing causes of cognitive symptoms. Also, newer blood-based Alzheimer’s biomarkers are now becoming part of specialty memory care. These tests can help estimate whether Alzheimer’s-type amyloid pathology is likely, but they should not be used as a stand-alone diagnosis or as general screening in people without symptoms. Results must be interpreted by clinicians in the context of the patient’s history, exam, cognitive testing, imaging, and overall medical condition.
One of the major advances in Alzheimer’s diagnosis is the ability to confirm amyloid plaques in the brain. This can be done with amyloid PET scan or, in some cases, cerebrospinal fluid testing. This is especially important now because the newest disease-modifying treatments require confirmation of amyloid pathology before starting therapy. DHR is proud to be the only institution in the RGV with amyloid PET scan capabilities.
For many years, treatment for Alzheimer’s disease focused mostly on symptom management. Today, in addition to symptomatic treatments, there are FDA-approved anti-amyloid monoclonal antibody therapies for selected patients with early Alzheimer’s disease. Leqembi (lecanemab) and Kisunla (donanemab) are intravenous treatments designed to reduce amyloid plaques in the brain. They are not cures, and they do not reverse advanced dementia, but clinical trials showed that they can slow decline in appropriately selected patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease.
For more information or to speak to one of our medical experts, please call DHR Health Neuroscience Institute at (956) 362-8500.
