Summer 2006
Medical Commentary
Early Medical Evaluation
By Elisabeth Rushing, MD
Alzheimer's disease (AD) is the most common cause of cognitive impairment in the elderly. Although it is a devastating and progressive neurodegenerative disease, the good news is that symptoms and outcome can be improved and its course altered. Early medical evaluation of patients with cognitive decline is the first critical step to ensure optimal care. A correct diagnosis early in the course of the illness facilitates the appropriate education for patients, family members and caretakers and optimizes the effects of therapeutic intervention. Generally speaking, the most accurate diagnoses come from clinicians with extensive experience in neurodegenerative disorders. A neurologist, preferably one with subspecialty training in this field, is best qualified to coordinate the comprehensive medical evaluation and treatment options.
More specifically, the initial manifestations of Alzheimer's disease and other forms of dementia can be subtle and sometimes mimic other diseases that are potentially treatable. For example, occasionally a screening test obtained as a part of the neurological examination will identify an underlying systemic disease that can be addressed and improve or even cure the patient's symptoms. In addition, a neurologist with expertise in dementia is more likely to be aware of emerging biochemical and imaging diagnostic methods that hold the potential to accurately predict the natural history of Alzheimer's disease and likelihood of a therapeutic response.
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From the Director: A Mix of Emotions
