How do I conduct a consultation for suspected dementia?

If there are complaints about memory decline and suspicion of dementia

First, you need to schedule an initial appointment with the neurologist specializing in cognitive impairments, G.N. Akhmadeeva.

It is preferable for a relative who lives with the patient to be present at the appointment.

1️⃣ First – a survey and thorough medical history collection (including medication history)

What was the first symptom and how long ago?

How everything developed so quickly

Have there been any visits to doctors

What were the treatment attempts (names of medications, dosages, duration of treatment, was there an effect, and how was the medication tolerated)

What comorbidities are there

What medications have you taken previously (for other conditions)

Is there a family history (have any close relatives experienced something similar)

2️⃣ Neurological examination (to identify neurological symptoms – this can aid in diagnosis, for example, early development of any neurological signs is not characteristic of Alzheimer’s disease. In contrast, early development of parkinsonism syndrome is typical for dementia with Lewy bodies)

3️⃣ Neuropsychological Testing – identify the predominant profile of cognitive decline, this will also help in differential diagnosis. For example, the amnestic type is characteristic of Alzheimer’s disease

4️⃣ We establish a preliminary diagnosis and discuss the strategy for further examination. Often, these are routine laboratory tests and neuroimaging. The method of choice is MRI of the brain in neuroregeneration mode using special programs to detect local atrophy or specific neuroimaging markers.

5️⃣ We recommend preliminary treatment and schedule a follow-up visit with a neurologist. This is usually 3-4 months, as it is within this period that it makes sense to assess the effectiveness of the prescribed medications.

In the presence of hallucinations or delusional/paranoid ideas (delusions of harm, fear of loss, etc.), a follow-up visit is scheduled with the gerontopsychiatrist of our Center – F.F. Kashapov. In this case, the prescription of antipsychotic drugs and mood stabilizers is required – but this is the “heavy artillery” (treatment almost never starts with them). Most often, such a follow-up examination is conducted jointly with a neurologist.

During the follow-up visit, the results of additional examinations are evaluated, based on which both the diagnosis and further treatment may be adjusted.

Further observation – if necessary, more often once every six months or less frequently

We want to remind you – dementia CAN and SHOULD be treated!

Symptoms of dementia CAN and SHOULD be controlled – to improve the quality of life for the patient and caregiver relatives

We will be happy to assist you during your visit to our Center for Extrapyramidal Pathology and Cognitive Disorders.