Alzheimer’s disease and dementia are difficult diagnoses because there is no cure and a patient will inevitably decline.
It is still important to build a relationship with a neurologist, as they can make a proper diagnosis and help manage symptoms and care decisions.
Cognitive disorders like dementia or Alzheimer’s disease are hard diagnoses to deal with. There is no cure, and the patient’s abilities will inevitably decline, not improve.
However, there are still many benefits to building a relationship with a neurologist.
A doctor can determine why the patient’s cognitive abilities are suffering. Then, they can help provide proper treatment and support.
Jesus Martinez, MD, practices neurology at Regional One Health’s East Campus.
“There are treatments available to manage, but not cure, conditions like dementia or Alzheimer’s disease,” he said. “The toughest thing is deciding what to do for patients and families when they know where the condition is heading. We can offer a shoulder to lean on and a hand to hold.”
It is essential to visit a neurologist as soon as cognitive issues emerge to get the right diagnosis. “There is no imaging test or bloodwork that can tell you, ‘This is dementia,’” Dr. Martinez noted. “The tests are of the oral or written variety. It’s a clinical diagnosis.”
Your neurologist will get a detailed medical history. They will ask questions about the patient’s cognitive impairments and ability to complete everyday tasks. They will conduct tests that provide insight into a patient’s memory, learning and problem-solving skills.
There is no lab or imaging test to check for dementia or Alzheimer’s disease, so neurologists talk to and observe patients in order to make a clinical diagnosis.
Dr. Martinez said one goal is to determine how a patient’s ability has declined. This can be extra challenging in high-functioning patients. They can often pass standard tests easily, yet are not performing at their former elite level.
Another important component to a dementia or Alzheimer’s diagnosis is the patient’s ability to perform normal tasks. Someone who struggles with ordinary household chores or their day-to-day work responsibilities could have a cognitive impairment.
Neurologists also look for other causes. A patient who fears a dementia or Alzheimer’s diagnosis could actually be suffering from something reversible.
A tumor can impact brain function. If he suspects a tumor, Dr. Martinez orders imaging.
A basic physical exam can also reveal causes. “An underlying illness or poor nutrition can cause confusion, and depression can also cause these issues,” Dr. Martinez said. “Or, sometimes it turns out the person simply needs a hearing aid.”
If he does diagnose dementia or Alzheimer’s disease, there is help available for the symptoms.
Medications can help with memory loss, confusion and reasoning. They target chemicals that carry messages in the brain to reduce or stabilize symptoms for at least a while. Doctors might also prescribe medication for dementia-related depression.
A neurologist can help patients manage the symptoms of dementia and Alzheimer’s disease, and work with families on care plans.
Doctors can also direct behavioral therapy. Some therapies aim to jog memory. Others improve coping skills or seek to improve mood and quality of life.
Dr. Martinez can also point patients and families toward support groups. In later stages of the disease, he works with families on needs like assigning power of attorney.
In that way, a neurologist can be valuable for loved ones as well as the patient.
Sometimes it is a doctor who convinces a patient to give up driving or living alone. Dr. Martinez tries to help families navigate difficult conversations by providing the perspective of someone who is both an expert and not emotionally involved.
“As neurologists, we recognize that many of the conditions we treat don’t have a cure,” he said. “We help patients and families live with a new normal and make their condition manageable so they can live their lives as normally as possible.”