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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
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
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
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
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
1. Complete Medical History
2. Psychosocial Interview
3. Neurological Examination
4. Psychiatric examination
5. Neuropsychological tests
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
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
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
1. Mood
Depression, anxiety, lability
2. Psychosis
Delirium, hallucinations, paranoia
3. Thought Process
Disorganized, incoherent
4. Affect and Appearance
Normal, sad, anxious, restless, unstable
SECTION TITLE HEADER 14PT HELVETICA BOLD
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
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