Memory Disorders: Evaluation and Diagnostic Process

Memory Disorders Clinic Miller School of Medicine Department of Psychiatry and Behavioral Sciences

Gloria M. Peruyera, MS Clinic Coordinator and Manager Research Support

Alzheimer’s Disease Initiative

Department of Elder Affairs

State of Florida

Alzheimer’s Disease Initiative

Department of Elder Affairs

State of Florida

1. Alzheimer's Disease Initiative established in 1985 by

the Florida Legislature

2. Clinics for evaluation and diagnosis of memory

problems

3. In-Home Respite Program

4. Adult Daycare Centers

5. Scientific research programs

Forgetfulness, a normal part of

aging or the beginning of

dementia?

Memory and Normal Aging

Memory and Normal Aging

1. Memory lapses are not always serious.

2. Many older people take longer to remember things.

3. Although they are more forgetful remain alert and in

possession of his faculties.

4. Their difficulties do not become more severe as time

passes.

Dementia

Dementia

1. Remembering recent events or conversations

2. Disorientation about time and location

3. Problems in performing daily activities

4. Finding simple words and expressing thoughts

5. Difficulty in trying to solve problems

6. Trouble handling money and execute complex tasks

7. Changes in personality or behavior

There is difficulty with one or more of the following:

Dementia

1. Dementia is a group of symptoms is not a disease in

itself

2. There are many causes of memory loss and

dementia

3. Some conditions are treatable or reversible

4. Alzheimer's disease is the most common type of

dementia

The Importance of a Complete

Medical Evaluation

The Importance of a Complete

Medical Evaluation

1. Identify the cause of memory loss

2. Exclude other treatable conditions

3. Get a good diagnosis

4. Implement treatment and monitoring

5. Inform family members about the disease and make

referrals

The Importance of a Complete

Medical Evaluation

1. There is not a specific test to determine clinical

Alzheimer's disease

2. Diagnosis is made through an assessment process

consisting of several tests and clinical examinations

The Diagnostic Process

The Diagnostic Process

1. Complete Medical History

2. Psychosocial Interview

3. Neurological Examination

4. Psychiatric examination

5. Neuropsychological tests

Clinical Diagnostic Process in

Memory

Clinical Diagnostic Process in

Memory

1. Psychosocial Interview

2. Neurological evaluation

3. Psychiatry evaluation

4. Cognitive Testing

5. Diagnostic Conference

6. Diagnostic Conference with Family

Psychosocial Interview

Psychosocial Interview

Family

1. Medical History: What, When, and How?

2. Assessment of daily functioning ability

3. Family Medical History

4. Demographic and socio-cultural factors

5. Family or caregiver education

Psychosocial Interview

Patient

1. Observation and interview

2. Mood

3. Mental Status Examination

Neurological Examination

Neurological Examination

Family

1. Medical and neurological history

2. Medication Review

3. Symptoms Assessment

Neurological Examination

Patient

1. Physical examination

2. Testing reflexes, sensory and motor functions

3. Other procedures: brain scan tests e.g. MRI, CT,

EEG

Psychiatric examination

Psychiatric examination

1. Mood

Depression, anxiety, lability

2. Psychosis

Delirium, hallucinations, paranoia

3. Thought Process

Disorganized, incoherent

4. Affect and Appearance

Normal, sad, anxious, restless, unstable

Cognitive Testing

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Cognitive Testing

1. Neuropsychological Assessment

to measure memory and cognitive abilities of the

patient

Orientation, attention, memory, use of language

skills, name objects, do simple calculations,

draw figures

2. A neuropsychological assessment can take between

one and five hours

Diagnostic Conference

Diagnostic Conference

1. Clinical team reviews the results of all examinations

and tests

2. Agrees on the diagnosis

3. Recommend treatment

4. Formulate a monitoring plan

Diagnostic Conference with the

Family

1. Inform the patient and family about the diagnosis

2. Explain the disease process

3. Prescribe and explain the use of medicines

4. Answer questions and provide support

5. Make referrals to other health professionals and

community resources

Memory Disorders Center

Miller School of Medicine Department of Psychiatry and Behavioral Sciences Center on Aging 1695 NW 9th Avenue, Suite 3204B Miami, FL 33136 (305) 355-9065