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KittyJo Asked April 2014

Is a diagnosis of dementia by a neurologist significantly important?

Several of my Moms doctors have told us that my 89 year old Mom has dementia. There is no doubt that this is not true, my brother and I are very aware. Mom has resided in a nice Resthome for 6 years and is well cared for.

Her primary care doctor asked if we wanted a referral for her to see a Neurologist for a diagnosis and determination of Alzheimer's vs. other types of dementia. Her advanced osteoporosis, blindness and increased confusion makes it difficult to take her to appointments.

Is it really important for her to see a Neurologist when we all agree that she has dementia onset?

pamstegma Apr 2014
Not just any Neurologist, but one who specializes in Alzheimers and dementia. Once you see the images of the brain, you will understand the effect of old age.

GraceofGod Apr 2014
If by onset you mean she is in the "beginning stages" than I believe it would be beneficial to see the neurologist to determine what medication can slow the progression of the disease. Dementia can not be reversed or cured so it is possibly the only way to go if your parent has awareness most of the time and is just beginning to show signs. I don't know what type of dementia your parent has however my mother has "stroke dementia" which will progress with each stroke , she has had 3 and I believe that the medication has helped..

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igloo572 Apr 2014
I'm going to vote for her to see the neurologist, I'm assuming this is geriatric neurologist. The type of dementia does make a difference in both medications best used and also in what the "progression" of her disease is likely to take. My mom saw her regular internal medicine MD till her late 80's and really his viewpoint was that all dementia's are Alzheimer's and that mom was just fine and for every concern or complaint she had it was a new prescription. Their medical training is all about curing and so often is a total waste of medications for those with dementia.

Mom tore her rotor cuff and needed surgery and the ortho guy required that mom get an evaluation by a gerontologist before he would do surgery. Ortho was with med school and she got into the gerontology program via his referral. It was a huge - and I am not exaggerating - difference in approach to her care and her needs. She saw the gerontolgoist, neurologist and other specialists in the department. It was determined that she has Lewy Body Dementia. Lewy is pretty different than ALz and she is pretty classic Lewy in how she has changed in her cognitive abilities. She pretty well sailed through the surgery too and did the rehab well and went back to her home and then into IL for a couple of years and now is in NH and is now on hospice (she fell and shattered her hip in June).

Her quality of life was very much better by seeing the gerontology group. Some of the meds usually given for ALZ are totally contraindicated for Lewy and can cause psych. severe issues - so yes it is important to have the right diagnosis. Most doc's really do not have the training to determine the difference in dementia's so seeing a neurologist could be really the best way to provide a care plan for her. The right medications in my experience do make a difference to enable them to be more competent with their ADL's and cognitive in their interactions; the right meds based on a good diagnosis will slow down the disease - it very much did that for my mom.

blannie Apr 2014
I agree with Veronica, if she's doing ok where she is now, I'm not sure knowing what type of dementia she has would change anything. It seems that even when docs know what kind of dementia they're dealing with, they still have to try different meds to see which ones work on each patient if someone needs medication. You could always take her in the future if you run into issues that make caring for her difficult.

Veronica91 Apr 2014
I would say why put her through it. It is probably too late to use the drugs available to slow the progression of ALZ. Maybe the Dr simply offered that as many people do want answers. As she is settled and calm in a facility I would not be inclined to do anything to upset her.This comes under the heading of " if it aint broke don't fix it"

bookluvr Apr 2014
I'm not as familiar as this as others here on AC. I do know that by going to see a neurologist can help determine which kind of dementia she has (there are several kinds) and what stage she is. Or the neurologist can recommend some kind of xrays or ultrasound or MRI ?? (I get confuse on this) to see how badly her physical brain is. I think it's also good if your mom sees a geriatric doctor (specializes on the elderly). He's familiar with the common problems/stages as their patients progress in their disease. You won't have to bang your head against the wall like one does with a regular doctor to get some kind of help.

It's very important to diagnose which dementia she has because some meds are great for Alzheimer but is really bad for those who have Lewy Body dementia. Each disease have their own "trademark" on what you can expect as they progress.

So, yes, I think it would be great for everyone if you know what she has so that you can research on it and prepare yourselves as your mom continues to deteriorate.

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