What “Brain Tests” Can Reveal

As you get older, it’s not unusual to have “senior moments”—when you have trouble finding the word you want, or forget what it is you went into the other room for. It’s also natural to be concerned about the possibility of having Alzheimer’s disease (AD), since more than 5 million Americans are currently living with AD, and that number could reach as high as 16 million by 2050. How do you know when it’s time to seek an evaluation?

“We all forget things, and some degree of forgetting is normal. However, if memory or other cognitive concerns are interfering with your daily routine, then it’s a good idea to get checked out,” says Lisa Ravdin, PhD, director of the Weill Cornell Neuropsychology Service in the Department of Neurology and Neuroscience.

Warning Signs

Since memory lapses are not uncommon among older adults, here are some examples of other signs that suggest a memory disorder:

Misplacing things and finding them in odd places

Difficulty completing familiar tasks, such as balancing the checkbook, paying bills, or making a favorite recipe

Asking the same questions or saying the same thing repeatedly

Types of Testing

If you’re experiencing memory problems, report it to your primary care physician; he or she may refer you to a neurologist, psychiatrist, psychologist, or neuropsychologist for testing. A neuropsychologist is a PhD-level psychologist with expertise in brain-behavior relationships.

One test that is frequently used for an initial assessment of mental function is the Mini-Mental State Examination (MMSE). However, neither this test nor any other test provides a definitive diagnosis of AD or dementia.

WHAT YOU SHOULD KNOW

The Alzheimer’s Association provides this list of 10 warning signs of AD:

  • Memory loss that disrupts daily life
  • Challenges in planning or solving problems
  • Difficulty in completing familiar tasks at home, work, or leisure
  • Confusion with time or place
  • Trouble understanding visual images and spatial relationships
  • New problems with words in speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood and personality

What about memory tests you can take online?

“I don’t usually recommend online tests, since they cannot differentiate between cognitive decline due to normal aging and the possibility of a neurodegenerative process such as AD,” says Silky Pahlajani, MD, a memory disorders specialist at Weill Cornell Medicine.

Other tests might include physical and neurological exams and brain imaging, such as an MRI (magnetic resonance imaging), CT scan (computerized tomography), or PET scan (positron tomography).

“Imaging tests can reveal whether there are structural changes in the brain, such as a stroke or tumor, that may explain cognitive deficits,” explains Dr. Ravdin.

“Imaging helps identify potential causes of brain dysfunction. Your brain changes as you get older, so some degree of brain cell loss and vascular changes are common and expected,” adds Dr. Pahlajani. However, changes seen on brain scans may or may not explain the cognitive changes the patient is experiencing; imaging results need to be interpreted in the context of other clinical findings.

A new type of imaging test, an amyloid PET scan, has been shown to detect moderate to severe amyloid deposition in the brain. This technology has recently been validated in improving diagnostic accuracy of AD. However, it’s not currently covered by insurance companies and should be ordered on a case-specific basis, says Dr. Pahlajani.

Risk Factors

Researchers have not yet identified any treatment that can prevent or cure AD, so it’s important to address the factors that increase your risk of AD.

“A major focus of the 2017 Alzheimer’s Association International Conference (AAIC) was on lifestyle modification and identification of risk factors that contribute to or accelerate the disease process. Research reported at AAIC identified nine significant risk factors—high blood pressure, obesity, hearing loss, depression, diabetes, sedentary lifestyle, smoking, level of education, and infrequent social contact—that are associated with an increased risk of AD,” says Dr. Pahlajani.

Vitamin deficiencies, medication side effects, stress, depression, and thyroid disease are just a few of the other factors that can affect your memory.

“There are many reasons why someone may have problems with memory,” says Dr. Ravdin. “A proper evaluation is essential because it can help to identify the cause of memory issues, which may be something that is treatable.”

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