What Is Dementia Symptoms Types And Diagnosis
Dementia is the loss of cognitive functioning thinking, remembering, and reasoning to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.
Dementia is more common as people grow older but it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia.
There are several different forms of dementia, including Alzheimers disease. A persons symptoms can vary depending on the type.
Brain Imaging In Patients With Cognitive Complaints Need To Be Viewed Differently When Using Mri To Diagnose And Treat Patients With Dementia Says Dr Christopher Hess Who Will Discuss The Role Of Mri In The Adjunctive Diagnosis Of Dementia In His Talk At The Garmisch Symposium
In addition, general radiologists need to recognize the important findings related to dementia when making a diagnosis. While MRI is mainly called for in patients with suspected dementia to exclude other abnormalities, there are characteristics of dementia that clinicians can look for when reading the exams, such as specific patterns of regional brain atrophy or structural lesions in areas of the brain that alter cognition, Hess says. In his talk, Hess will discuss how radiologists can use these findings to support or refute the diagnosis of specific neurodegenerative processes, as well to recommend appropriate next steps in disease evaluation and management. He will share the approach that he takes with other clinicians during the talk.
In his talk, Hess will discuss how radiologists can use these findings to support or refute the diagnosis of specific neurodegenerative processes, as well to recommend appropriate next steps in disease evaluation and management. He will share the approach that he takes with other clinicians during the talk. Brain MRI is often the first step in evaluation, Hess says. General radiologists dont necessarily recognize the important findings related to dementia. We will review dementia symptoms and how they should guide the eyes of radiologists, and look carefully at the critical importance of distinguishing between rapidly progressive and chronic dementia.
Here are some key takeaways from Hesss talk:
Profile:
Session:
Assessment Of Signal Change
Signal intensity within a single tissue type should be reasonably uniform on MRI. The presence of regions of hyperintensity or hypointensity within the tissue typically reflects pathology. In the context of a suspected dementia, punctate or confluent regions of signal change within white matter or deep grey matter are most commonly associated with vascular pathology, but rarely may also indicate inflammatory, metabolic or infective processes. The prevalence of vascular cognitive impairment is second only to AD. They share many risk factors, including an increasing prevalence with age, and therefore, in many patients vascular and degenerative pathology coexist. The exact interaction between neurodegenerative and vascular pathology is debated but critically for the patient, it is important that vascular risk factors are managed and treated. Differentiating the relative contribution of vascular from neurodegenerative pathology as the cause of a patient’s cognitive problems is a common clinical problem where MRI plays a central role. If MRI is not possible, CT can also be used relatively effectively to evaluate the presence and extent of cerebrovascular disease, with changes in white matter appearing hypodense.
FLAIR/T2 hyperintensity
T2* hypointensity
T2* hypointensities may also result from calcification, iron deposits , haemorrhagic metastasis or diffuse axonal injury. Care should also be taken to exclude MR artefacts such as flow voids or signals from temporal bones.
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Physical & Neurological Exam
A specialist may administer physical or neurological exams to rule out certain conditions. Unfortunately, there is not a single diagnostic test that can diagnose Alzheimers, so doctors rely on other tests to rule out any other condition that could explain the dementia-like symptoms.
Administering physical exams when you suspect Alzheimers disease is largely used to rule out other conditions that could be causing your dementia symptoms. These dementia-like symptoms may be caused by depression, untreated sleep apnea, side effects of pharmaceuticals, or certain vitamin deficiencies.
Physical exams for diagnosing Alzheimers disease may include:
- Measuring blood pressure, temperature, and pulse
- Monitoring heart and lungs for abnormalities
- Collecting blood samples or urine samples for lab testing
- Reviewing what medications youre taking
- Talking about your sleep habits
- Going through your diet, nutrition, and alcohol consumption
With a neurological exam, doctors can rule out neurological conditions that could be causing your dementia-like symptoms. These conditions may include tumors, fluid accumulation on the brain, Parkinsons, or strokes large and small.
Neurological exams for diagnosing Alzheimers may include:
- Testing reflexes
- Brain imaging
With Alzheimers Disease Prevention Is Key
There are many ways to diagnose Alzheimers, although a definitive diagnosis cannot be achieved except in an autopsy, where brain tissue can be precisely examined. Typically, doctors use various tests to rule out conditions that could explain dementia-like symptoms.
Patients diagnosed with Alzheimers disease live another 4-8 years, on average, after their diagnosis.
However, you dont have to sit back and wait for Alzheimers to take its toll. Some patients live up to 20 years after their diagnosis!
Because most if not all conventional dementia treatments have about a 1% chance of success, the need for a revolutionary new approach is critical for treating dementia and Alzheimers.
At PrimeHealth, Dr. David Ward hosts an Alzheimers Prevention Program incorporating Dr. Dale Bredesens revolutionary, evidence-based lifestyle approach to optimize cognitive function. Schedule an appointment with us and learn more about PrimeHealths Prevention Program.
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Basics Of Structural Mri As Applied To Ad
MRI utilizes the fact that protons have angular momentum which is polarized in a magnetic field. This means that a pulse of radiofrequency can alter the energy state of protons and, when the pulse is turned off, the protons will, on returning to their energy stage, emit a radiofrequency signal. By a combination of different gradients and pulses, sequences can be designed to be sensitive to different tissue characteristics. In broad terms structural MRI in AD can be divided into assessing atrophy and changes in tissue characteristics which cause signal alterations on certain sequences such as white matter hyperintensities on T2-weighted MRI as a result of vascular damage. A number of MR sequences that are sensitive to microstructural change have shown alterations in AD. These sequences are already important research tools however, they have not yet found a place in routine clinical practice in AD and they will not be considered further here.
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Training To Spot Dementia
To improve dementia diagnosis rates and ensure referrals are appropriate in the UK, the RCGP is currently teaching GP trainees to better spot the signs of dementia.GPs have had more and more thrust on them over the years they dont have the specialist knowledge of dementia, so better support is needed, says Dr Hayo.New models of care are also introducing more help for patients and healthcare professionals.NHS High Weald Lewes Havens Clinical Commissioning Group and Buxted Medical Centre in East Sussex have joined up with the local council and several charities to deliver more joined-up care for dementia patients.Their golden ticket service gives patients a single point of contact for their care. They meet with a dementia guide within two days of a diagnosis, and can access personalised advanced care planning. Early evaluations show that it is already reducing GP visits and emergency admissions to hospital.Meanwhile, a scheme commissioned by NHS South Norfolk CCG links specialist dementia nurses with GP practices to give dementia patients direct support.7 A similar scheme in Norfolk saved £440,000 over 10 months, reducing contact time with GPs by 60% and with nurses by 16%.More help for GPs to diagnose and refer patients appropriately better access to diagnostic scans clear pathways for patients to access support. Together, these should help to reduce diagnosis delays and improve patient care.Then, perhaps the wait for a diagnosis might not be so long.
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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 .
Frederik Barkhof Marieke Hazewinkel Maja Binnewijzend And Robin Smithuis
Alzheimer Centre and Image Analysis Centre, Vrije Universiteit Medical Center, Amsterdam and the Rijnland Hospital, Leiderdorp, The Netherlands
Publicationdate 2012-01-09
This review is based on a presentation given by Frederik Barkhof at the Neuroradiology teaching course for the Dutch Radiology Society and was adapted for the Radiology Assistant by Robin Smithuis.First publication: 1-3-2007.Updated version: 9-1-2012.This presentation will focus on the role of MRI in the diagnosis of dementia and related diseases.We will discuss the following subjects:
- Systematic assessment of MR in dementia
- MR protocol for dementia
- Typical findings in the most common dementia syndromes
- Alzheimer’s disease
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Exclusion Of Surgical Pathology
The exclusion of a structural brain lesion potentially amenable to surgical intervention should be the starting point when reviewing structural imaging. These include tumour , subdural haematoma, arteriovenous malformation and hydrocephalus. Idiopathic normal pressure hydrocephalus should also be considered, although imaging markers have not yet proved sensitive enough for reliable diagnosis.,
Can An Mri Diagnose Alzheimers
The simplest answer to the question is yes. The more complicated answer considers that there is still a lot of research to do on this disease, so it may be a while before we establish a definitive test to diagnose Alzheimers disease.
However, for the time being, using an MRI to detect Alzheimers is one of the best options available.
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What To Expect With A Head Ct Scan
If you decide to get a head CT scan, the process usually starts with contrast dye. Depending on your situation, this may be ingested orally or intravenously with a needle. This is simply dye that allows the images to show up on the screen.
Then, you get into the CT machine. While there are some standing CT machines, you generally need to use a machine that lets you lie down for a head scan. During the procedure, there is no pain, and in fact, all you have to do is stay still. Note that you may hear some noises, and some people feel anxious due to the confined space. If you anticipate feeling worried during the procedure, you may want to talk with your doctor about anti-anxiety medicine.
Facing the idea that you might have Alzheimers can be incredibly scary, but its important to remember that the earlier you detect the more likely you are to be able to manage the symptoms. To set up an appointment, contact American Health Imaging today.
Testing For Vascular Dementia
However, timely access to these scans depends where you live in the country, according to Dr Hayo.This corresponds with Dr Taylors experience. isnt too bad at the moment where I work, but I have known long waits in the past, she says.Where I work, the referral form asks us to consider doing a head CT and we can order this directly, but thats not the case for GPs everywhere, she says.Dr Hayo says that CT scans are the cheapest option but not the most useful for diagnosing dementia. MRI scans are more appropriate because they can pick up subtle changes in the brain.Many people cant access MRI in some areas there is a four-month wait, she says. And the scan reading ability of the person who reports on the scan can vary as well as not everyone is skilled in identifying the early changes of dementia.Patients are usually then referred to a memory assessment clinic if they require specialist assessment. But this is another area where waiting times can slow down diagnosis.
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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
What Are The Symptoms Of Dementia
As the mind is a complex thing, so too can be the symptoms of dementia. While the early signs of the condition can vary from person to person, the symptoms listed below are the most common:
- Memory loss that starts to impact day to day life
- Changes in your ability to plan or problem solve
- Struggles in completing familiar tasks
- Confusion, particularly surrounding times and places
- The trouble with spatial awareness
- Vision problems
- Changes in personality or mood
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Mri Scans As Accurate As Lumbar Punctures In Identifying Alzheimers Or Ftld
They found that by studying the structural brain patterns the density of gray matter on the MRI scans, their predictions were 75% accurate when confirming diagnosis with people who had pathology-confirmed diagnoses and those with biomarker levels retrieved from lumbar punctures this shows that the new MRI use is as accurate as lumbar puncture methods.
McMillan said:
Developing a new method for diagnosis is important because potential treatments target the underlying abnormal proteins, so we need to know which disease to treat. This could be used as a screening method and any borderline cases could follow up with the lumbar puncture or PET scan.
This method would also be helpful in clinical trials where it may be important to monitor these biomarkers repeatedly over time to determine whether a treatment was working, and it would be much less invasive than repeated lumbar punctures.
How A Head Ct Scan Can Detect Alzheimers Disease
A head CT scan looks at the structure of your brain. This scan can detect issues such as tumors, hemorrhages, and strokes, which can all mimic the symptoms of Alzheimers, but in addition to helping you rule out those conditions, a CT scan can also detect the loss of brain mass thats associated with Alzheimers disease.
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Why Doctors Consider Mri To Detect Dementia
Medical experts will advise on the use of MRI when they suspect that a person has dementia.
MRI uses focused radio waves and magnetic fields to detect the presence of hydrogen atoms in tissues in the human body.
MRI scans also reveal the brains anatomic structure with 3D imaging allowing doctors to get a clear view of the current state of the organ.
This way, the doctor is able to rule out other health problems like hydrocephalus, hemorrhage, stroke, and tumors that can mimic dementia.
With these scans, physicians can also detect loss of brain mass that relates to different types of dementia.
fMRI records blood flow changes that are linked to the activities of the brain. This may help physicians differentiate dementia types.
Verywellhealth.com also suggests that MRI scans can at times identify reversible cognitive decline.
In such a case, a doctor will recommend appropriate treatment that will reverse this decline and restore cognitive functioning.
How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
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