Preliminary Evaluation and Referrals for Patients with Dementia

The definitive diagnosis of Alzheimer's disease is still an autopsy of the brain.  Today with the use of brain scans and spinal taps that may detect specific biomarkers of Alzheimer's but, there is still no single test for a diagnosis with 100% accuracy. 

Most family physicians have worked with patients who have different types of dementias.  Many physicians, unless they specialize in working with geriatric patients, do not have the time nor the staff and equipment to make the differential diagnosis for many dementias.  I will consult with your physician, and you and your loved one to assist in referring you to a team who can do the battery of testing for specific dementias.  The work-up usually consists of CT and MRI scans, a complete history and physical, often two days of neuropsychological testing, extensive laboratory tests, possible spinal tap, and interviewing the patient and his or her spouse.

I often refer families to Helena Chang Chui, MD at Keck School of Medicine at USC.  Dr. Chui is internationally recognized for her research in Alzheimer's disease and vascular cognitive impairment.  I have also referred families to Gary Small, MD, Professor of Psychiatry and Bio-behavioral Sciences and Parlow-Solomon Professor on Aging at the David Geffen School of Medicine at UCLA.  He is also the Director of the UCLA Longevity Center.