Additional Tests To Treat And Manage Dementia
Once an individual is diagnosed with dementia, the next step that follows is helping them understand how the condition will affect them and how to manage it.
Several other medical assessments exist to help physicians understand how the condition affects a specific person. And also help families, as well as caregivers, figure out the best course of treatment for the individual.
Did you HEAR of the peanut butter test?
Neuropsychological Testing
Neuropsychologists and psychologists who have specialized training can also prescribe neuropsychological tests to detect dementia.
The process involves WRITTEN and ORAL tests that can take several hours to complete.
They use these methods to assess the cognitive functions of the person suspected to have dementia.
It helps them figure out if certain areas are impaired.
The tests assess aspects like vision-motor, memory, comprehension, reasoning, coordination, and writing abilities.
Physicians may administer additional tests to find out if the person in question is SUFFERING from mood problems or dementia.
Functional Assessments
Dementia is a cognitive disorder that affects the afflicted persons daily functioning in different regards.
Objective assessments can establish what a person is STILL ABLE to do versus what they can no longer do in light of the condition.
Family members are asked to fillquestionnaires that provide details about the persons daily life in terms of the activities they are able to perform.
Psychosocial evaluation
Future Directions In Diagnosis Research
Considerable research effort is being put into the development of better tools for accurate and early diagnosis. Research continues to provide new insights that in the future may promote early detection and improved diagnosis of dementia, including:
- Better dementia assessment tests that are suitable for people from diverse educational, social, linguistic and cultural backgrounds.
- New computerised cognitive assessment tests which can improve the delivery of the test and simplify responses.
- Improved screening tools to allow dementia to be more effectively identified and diagnosed by GPs.
- The development of blood and spinal fluid tests to measure Alzheimers related protein levels and determine the risk of Alzheimers disease.
- The use of sophisticated brain imaging techniques and newly developed dyes to directly view abnormal Alzheimers protein deposits in the brain, yielding specific tests for Alzheimers disease.
Brain Imaging Tests Used To Diagnose Dementia
Although a brain scan alone does not diagnose dementia, it can be a strong indicator when included as part of a wider assessment. Once simpler tests, such as blood tests and mental ability tests, have been used to eliminate other possible conditions, a brain scan can confirm dementia as the patients diagnosis.
In addition to helping diagnose dementia, a brain imaging test can check for other potential causes of common dementia symptoms, such as a brain tumor or stroke. If the symptoms are coming from a different source, they will require a different treatment, so an accurate diagnosis is imperative. With imaging tests, patients can be more confident they are receiving the correct treatment and following the right recovery plan.
While there is a variety of brain imaging tests patients could undergo, below are the most common for diagnosing possible cases of dementia.
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Brain Imaging Can Aid Professionals
In most cases, brain imaging can assist professionals in diagnosing dementia, ruling out other possibilities with similar symptoms and verifying which stage a patient may be experiencing. Using scans to analyze signs of dementia can exclude the possibility of lesions that cause cognitive degeneration or impairment .
It can also help to determine which kind of dementia a patient is experiencing. For instance, vascular dementia may not show evidence of a cortical loss, whereas this qualifier could still allow a patient to have Alzheimer’s disease. Also, by undergoing frequent scans, neurologists can make a determination of how the disease is progressing. If a diagnosis is uncertain, follow-up scans taken after a few years can prove that degeneration is occurring. Finally, brain imaging can assist researchers in determining how each disease can affect a patient, and whether certain treatments are effective.
Alternatives To A Head Ct Scan
Head CT scans may be the most effective way to diagnose Alzheimers disease. But if you prefer another method, magnetic resonance imaging of the head shows your doctor if you have mild cognitive impairment or brain shrinkage. Cognitive tests are available online to download, print and bring to a doctors office for a score. One option is the SAGE test from the Ohio State University Wexner Medical Center.
To get the most accurate diagnosis, your doctor may recommend combining tests and scans. For example, you can have a head MRI along with an assessment by your primary care doctor.
Facing the idea that you or a loved one might have Alzheimers disease is difficult. Its important though to not delay important imaging scans. Learn more about how CT scans help you and how to prepare for an upcoming appointment.
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Periventricular White Matter Lesions
Periventricular white matter lesions are an important component of the diagnostic criteria for vascular dementia . However, these lesions are present in other forms of dementia, depression and even in normal ageing. It is felt that bilateral or left-sided white matter lesions may be important predictors of dementia and cognitive impairment . Structural neuroimaging provides information about the volume, location and severity of vascular lesions and is an important tool for excluding other causes of cognitive impairment. Magnetic resonance imaging is more sensitive than CT in detecting ischaemic lesions . It has been suggested that the presence of periventricular white matter changes can help differentiate vascular dementia from Alzheimers disease, as both conditions are associated with cortical atrophy and ventricular enlargement on imaging .
Proposed Treatments Of Patients Having Ad With Ionizing Radiation
Bistolfi states that vascularcerebral amyloidosis is the hallmark of AD.24 Localized tracheobronchial amyloidosis has been successfully treated with beams of radiation, 20 Gy in 10 fractions of 200 cGy in 2 weeks. As 20 Gy in 2 weeks is followed by inflammatory reactions, this high dosage cannot be suggested in the hypothetical treatment of AD. An innovative alternative might be a weekly long-term low dose, say 50 to 100 cGy, fractionated radiotherapy , matching the very slow response of amyloid to radiation. Before applying it to patients with AD, the proposed schedule should be tried in patients with TBA to compare the new results of long-term fractionated RT with the results of 20 Gy/2 w. Should long-term fractionated RT prove effective, its application to patients with AD might become an effective and safe treatment.24
On July 17, 2013, an application for a patent was published, titled Radiation therapy for treating Alzheimers disease.27 It makes 14 claims for treating human patients by a method, which is based on studies carried out using mice. The method comprises administering a relatively large amount of ionizing radiation to the brain of the patient employing a variety of different radiation sources. The total dose ranges from 300 to 1800 cGy, administered in dose fractions of 50 to 300 cGy per day. The method is claimed to treat AD by reducing the number or size of amyloid plaques in the brain of the patient.27
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Schedule An Mri For Alzheimers Today
Early diagnosis is critical to slowing the progression of Alzheimers, and an MRI of the head is one of the best ways to do it. At Envision Imaging, were dedicated to providing world-class diagnostic imaging to enhance the quality of life for our patients.
No matter which of our many locations you visit, youll receive only the very best service from our staff of professionals who understand the stress that can surround a persons visit, so we ensure each client gets focused service with an excellent quality of care.
Find a location near you to schedule your MRI appointment today.
Data Extraction And Quality Assessment
Data extraction and quality assessment were completed by one reviewer and checked by a second disagreements were resolved through discussion or referral to a third reviewer. We extracted data on: inclusion/exclusion criteria, included patients, CT and MRI technical and operator details, reference standard, imaging finding, definition of a positive imaging finding, numbers of patients in each patient group , and number of patients with positive imaging findings in each group. The patient groups were dichotomised as VaD or mixed dementia compared to AD or other diagnoses. This allowed construction of 2×2 tables of test performance, separately for each imaging finding assessed. Study quality was assessed using the Cochrane Collaborations adaption of the QUADAS tool .
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Access To Memory Clinics
In England, people should be seen in their local memory clinic within six weeks of referral, but some clinics are exceeding this. The last publicly available audit in 20155 found that while the average waiting time was 5.4 weeks, 48 out of 182 memory services in England exceeded the six-week wait, and the longest recorded wait was 32 weeks.A county might have limited memory assessment services and so can soon generate long waiting lists, says Dr Hayo.
Strong demand also lengthens waiting lists. In addition, only a fraction of young-onset referrals leads to a diagnosis of dementia this can be as low 12% in West London, 19% in Cornwall6 and 27% in North Wales, according to the Royal College of Psychiatrists. False referrals clog up the system, as you spend two or three hours carrying out tests and scans on someone who doesnt need them, Dr Hayo says.To support GPs in referring appropriately for young onset dementia, The Young Dementia Network has developed a decision-making support and prompting tool for GPs that is backed by the Royal College of General Practitioners .Most GPs will only see one or two cases of young onset dementia through their career so they arent adequately equipped to recognise the early symptoms of young-onset dementia, Dr Hayo says. Thats something we hope the decision support tool can help with.
Appendix : Literature Search Strategies
| Search date: February 19, 2013Databases searched: Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, Embase Cochrane Centre for Reviews and Dissemination databaseLimits: 2000-present English NOT case reports, comments, editorials, lettersFilters: noneQuestion:Appropriate use of imaging in the diagnostic work-up for dementiaDatabase: Ovid MEDLINE < 1946 to February Week 1 2013> , Ovid MEDLINE In-Process & Other Non-Indexed Citations < February 15, 2013> , Embase < 1980 to 2013 Week 07> Search Strategy: |
| exp Cognition Disorders/ use mesz | 54585 | |
| exp cognitive defect/ use emez | 84437 | |
| adj2 )).ti,ab. | 273469 | |
| exp Tomography, X-Ray Computed/ use mesz or exp computer assisted tomography/ use emez | 817213 | |
| exp Magnetic Resonance Imaging/ use mesz or exp nuclear magnetic resonance imaging/ use emez | 747046 | |
| 160053 | ||
| 10 | .ti,ab. | 497288 |
| exp Predictive Value of Tests/ use mesz or exp predictive value/ use emez | 155007 | |
| exp Decision Support Techniques/ use mesz or exp medical decision making/ use emez | 116708 | |
| exp Disease Progression/ use mesz | 104008 | |
| exp Likelihood Functions/ use mesz or exp maximum likelihood method/ use emez | 19682 | |
| exp odds ratio/ use mesz | 51073 | |
| exp Diagnosis, Differential/ use mesz or exp differential diagnosis/ use emez | 663277 | |
| 13374 | ||
| 22 | .ti,ab. | 2278119 |
| limit 23 to english language | 10715 | |
| 25 | limit 24 to | 2397 |
| limit 26 to yr=2000 -Current | 7113 | |
| limit 27 to yr=2007 -Current | 4847 | |
| limit 27 to yr=2000 – 2006 | 2271 |
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Advice Please Are Brain Ct Scans Reliable In Showing Dementia
LYN T said:Yes-not a good thing to take no further action. Also my OH’s Dementia did show up on a CT scan but the Neurologist missed the VERY obvious signs of brain damage. Years later a Consultant looked at the same scan and it was then that I was told that Pete HAD Dementia for several years. Therefore, I would insist on having follow up appointments and even a second opinion on the CT scan.Take care
Perhaps the single most important conclusion from the study is that Alzheimer disease is not straight forward. In several cases, pathology studies of brain tissue from the deceased nuns did not correlate with their performance on cognitive function tests. Sometimes the pathologist would score a brain as having signs of extremely advanced AD, only to learn later that the nun herself scored extremely well on all cognitive tests. Other times a brain would show only slight damage associated with AD, and the nun was characterized as exhibiting the signs of advanced cognitive decline and dementia.
Early Warning Signs And Diagnosis
Alzheimers Disease can be caught in the early stageswhen the best treatments are availableby watching for telltale warning signs. If you recognize the warning signs in yourself or a loved one, make an appointment to see your physician right away. Brain imaging technology can diagnose Alzheimers early, improving the opportunities for symptom management.
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How Brain Scans Assist With Identifying Dementia
Alzheimers disease is the most common type of dementia. A CT scan or MRI can assist with identifying a physical change or brain condition contributing to dementia or Alzheimers symptoms: These signs include:
- Indication a stroke has occurred
- Tumors
- Cortical atrophy, or wrinkled ridges of tissue forming on the brain
- Changes in the brains structure and functioning, including loss of brain mass
While dementia may be a symptom of the above conditions, an atrophied hippocampus is a sign of Alzheimers disease.
While preferred, CT and MRI scans might not deliver the results a doctor is seeking. If tests come back inconclusive, positron emission tomography and single-photon emission computed tomography might be requested. These scans examine various aspects of brain activity, including oxygen use and blood flow, and can identify symptoms that separate Alzheimers from other types of dementia.
Additionally, an electroencephalogram may be requested to observe abnormal brain activity. While an EEG is not ideal for diagnosing Alzheimers disease, it can identify other conditions for which dementia and cognitive decline are symptoms. Furthermore, this test can detect the source of seizures an issue for roughly 10 percent of Alzheimers patients.
Signs You May Need A Head Ct Scan
Some people with a family history of Alzheimers disease or dementia get a scan proactively for peace of mind. Others may have the scan after showing these symptoms of Alzheimers disease:
- Behavioral changes
- Difficulty understanding others when they speak
- Loss of appetite
- Mood changes, including irritability and depression
- Problems with depth perception
Memory loss is not inevitable with aging. If your loved one has memory loss and any of the above symptoms, it may be time to speak with your doctor about further testing.
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How Do Ct Scans Show Dementia
The most common types of brain scan you might encounter are magnetic resonance imaging and computed tomographic scans.
Doctors regularly recommend MRIs and CT scans when they examine someone they suspect has dementia.
CT scans detect brain structures through X-rays and the procedure can reveal evidence of ischemia, brain atrophy, and strokes.
The procedure also picks up on PROBLEMS like subdural hematomas, hydrocephalus, and changes that affect the blood vessels.
As implied, MRIs make use of focused radio waves and magnetic fields to detect the presence of hydrogen atoms within the bodys tissues.
MRIs ARE BETTER at diagnosing brain atrophy and the damage that subtle ischemia or incidents of small strokes cause to the brain.
Thus, MRI is normally the first test a person undergoes and CT second.
Clinical Need And Target Population
Dementia
Dementia is a general term for the condition of memory loss, cognitive impairment, and/or personality and behavioural changes. Nearly 750,000 Canadians were affected by cognitive impairment and dementia in 2011, and the number of prevalent cases is projected to nearly double to 1.4 million by 2031. The various types of dementia result from different underlying brain pathologies and present with variable and typical symptoms that are described below.
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Brain Scans: Your Rights
Brain scans are not considered an essential part of a dementia diagnosis, so you arent automatically entitled to receive one on the NHS. Dementia Guidelines by NICE state that brain scans may not always be needed in those presenting with moderate to severe dementia, if the diagnosis is already clear. The guidelines also say that if you want a brain scan your GP must provide detailed clinical information suggesting why it is necessary.
In other words, those who are elderly, frail or already showing obvious signs of dementia you probably wont be offered a brain scan. But those who are young, or have symptoms which could also indicate other brain diseases such as tumours and cancers, should be referred to hospital for a scan, though the waiting times can vary from days to several weeks, depending on where you live.
How Is Dementia Treated
While there is no cure for some dementias, the progression of some types of dementia can be slowed or even reversed with treatment. Options include:
- Treating the cause of dementia when there is a treatable cause: This includes hormonal treatment for hypothyroidism, treating hydrocephalus with shunting, evacuation of subdural collections, etc.
- Cholinesterase inhibitors, a type of medication that may slow the progress of Alzheimer’s disease by helping people improve their attention and working memory.
- Medications to manage blood pressure, cholesterol, triglycerides, diabetes, and problems with blood clotting.
- Procedures to improve blood flow to the brain, such as carotid endarterectomy or Angioplasty and Vascular Stenting.
- Lifestyle modifications, such as following a healthy diet and adding an exercise regimen, quitting smoking and quitting or decreasing alcohol consumption.
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