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Medical Forum / Diseases and Disorders / Alzheimer's / January 2004

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comprehensive testing for AD symptoms

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gll - 30 Jan 2004 05:38 GMT
Hello,

I have a relative (74 years old) who exhibits varying but generally
slight degrees of memory loss and confusion.  Several family members
share this opinion, and although any one incident seems innocent enough,
it's almost impossible to spend even a brief time with her without one
or two "senior moments."  Some incidents seem to cross the line of
anything that would be explained by normal aging, and create genuine
concern.  She herself will talk of having "brain dead" days.

She has several ongoing medical issues, but none that are severe.
However, she takes a number of prescription drugs, including statins and
something related to a thyroid condition.  She also has a condition that
restricts all wheat and gluten products from her diet.

At our request, she's met with an internist (specializing in care of
seniors) and with a psychiatrist.  Both gave her what I consider trivial
cognitive tests, along the lines of  "do you know what day it is?".  Neither
doctor asked to speak with any friends or family members about their
perceptions, and the relative herself is often oblivious to incidents that
we think may be symptoms of something significant.

Can anyone help me identify a source for comprehensive testing of her
memory and cognitive skills?  In my (only semi-informed) opinion, this
needs to include detailed tests of her memory and cognition, a thorough
analysis of possible drug side effects or interactions, as well as
interviews
with people close to her.  On the chance that this is AD or some other
medical condition, we all want to catch it early and act accordingly.

Thanks in advance for any recommendations.  We are located in
Kentucky, but could travel within the US if that's what's needed to get
access to thorough and up-to-date testing.

Best regards,

Greg
Dennis P. Harris - 30 Jan 2004 07:03 GMT
> Can anyone help me identify a source for comprehensive testing of her
> memory and cognitive skills?  In my (only semi-informed) opinion, this
[quoted text clipped - 3 lines]
> with people close to her.  On the chance that this is AD or some other
> medical condition, we all want to catch it early and act accordingly.

she needs a full neurological & psychiatric evaluation, as well
as an evaluation of diet and medications, including over the
counter meds.  the best way to do this is to go to her house and
empty out the medicine cabinets, the kitchen cabinet, her purse,
and any other places she stashes meds.  

does she have a *written* med schedule, and does she have a pill
organizer, a box divided into columns and rows for days of the
week and times?  ask her when she takes what, and how many.
anything she doesn't know about, put aside.  make a list and give
the entire list to whoever's doing the exam (and check online web
sites --- just search google for "drug interaction).

if she can't pass a clock face test, (draw a circle, ask her to
make it into a drawing of a clock set for 3 p.m.  you may be very
surprised at the result), all the pill boxes in the world won't
help, because she may be taking her meds erratically, either
forgetting to take them, or forgetting she's already taken them
and taking them again (and again).

she needs to go to facility that has cat and MRI scanners and
neuro-psych staff that specializes in dementias and other
geriatric issues.

> Thanks in advance for any recommendations.  We are located in
> Kentucky, but could travel within the US if that's what's needed to get
> access to thorough and up-to-date testing.
Char - 31 Jan 2004 02:23 GMT
> > Can anyone help me identify a source for comprehensive testing of her
> > memory and cognitive skills?  In my (only semi-informed) opinion, this
[quoted text clipped - 31 lines]
> > Kentucky, but could travel within the US if that's what's needed to get
> > access to thorough and up-to-date testing.

Dennis is absolutely right.  There is no replacement for the thorough
day  or two day neuro-psych test.  Imho, we have gained more info from
these than all other tests combined.  CT's and MRI's can't be totally
relied upon---well, I shouldn't be so general.  Maybe in AD, yes---but
if it's one of the others, it seems to be an elimination game.

Always,

Char
 
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