June is Alzheimer's & Brain Awareness Month. While Alzheimer's Disease is the most common and the most widely known, it's far from the only type of dementia. In fact, Alzheimer's and other dementias so frequently coexist in the same person that it's not always clear exactly what's contributing to an individual's cognitive decline. Still, although generally speaking there's very little available in the way of treatment for dementia, it can be critical to rule out certain causes. For one thing, you obviously want to know if you're dealing with something reversible. And, it can be important to identify the type of dementia since some respond very poorly to typical medications we might use to help manage difficult behavior.
Luckily, when making an assessment we have some clues to go by and of these one of the most important is the history given by family members. A good clinician will take the time to get a thorough history in addition to ordering blood tests and brain imaging.
For patients whose cognitive decline is still in its early stages, or if the diagnosis is in doubt, I often make a referral for formal neuropsychological testing. Neuropsychological testing can provide diagnostic guidance as well as a benchmark against which to measure further decline. Here are some resources in New York City:
In the coming weeks I will post more on dementia-related topics, including the role of music; an interesting tool for speech and communication that can help patients feel less isolated; the difference between delirium and dementia; the use of medicinal marijuana; considerations regarding nutrition and hydration; and other resources for caregivers.