Mild dementia/ Alzheimer’s

sunshine5

I asked neurologist what type of dementia does DH has, is it Lewy body, he said no. He doesn’t know what kind, thinks probably has Alzheimer’s.

Is this a good answer?

DH restless leg and shaking in his sleep, neurologist says to have sleep study done. DH had sleep apnea before, ok now. Is this a sign Dementia getting worse?

These are not the answers i expect from a good neurologist!

Even if I know, what kind of Dementia he has, would he be treated differently?

DH had MRI done that shows dementia. What other tests should he have to have better diagnosis? He was diagnosed last July, about a year ago.

The only treatment he is having is low dose of Exelon patch and Montelukast tablet at night.

Would going to senior center help, being more social?

Crushed

Dementia is a Symptom

Normally we only have solid evidence of what type of dementia  a person has after death or after a long period with the disease. 

A standard neurology joke is the  more and more experience  you have You will start to understand the less and less you really know

 

jfkoc

Exactly...we get to AD etc by ruling out causes some of which are treatable. You will find information about the correct protocol for diagnosing online. It would be could to be certain that all the boxes were checked off.

Senior Center? I would encourage any/all activity that bring enjoyment to your husband. 

Now is the time to get all medical/legal/financial matter taken care of. This is best done with a certified Elder Law attorney.

Vitruvius

I was told that the PET scan is the most informative physical test. DW's neurologist stated in his written report that the PET scan was a major factor in determining that she had Semantic Dementia.  Her particular performance on the neuropsychological tests was the other major deciding factor.

Knowing the particular probable dementia is apparently somewhat useful in determining what meds might be most appropriate. It also helped me understand that she would display slightly different symptoms and that her progression would follow a slightly different path than AD. 

Crushed

Vitruvius wrote:

I was told that the PET scan is the most informative physical test. DW's neurologist stated in his written report that the PET scan was a major factor in determining that she had Semantic Dementia.

1

Primary progressive aphasia, semantic dementia and progressive agrammatic (nonfluent) aphasia are all considered to be frontotemporal dementia.   (MAYO CLinic)

  

https://www.mayoclinic.org/diseases-conditions/frontotemporal-dementia/symptoms-causes/syc-20354737

Quilting brings calm

It seems to me that those of you living in extremely large cities might be offered PET scans for dementia diagnosis, but the rest  of us don’t seem to.  My 200,000 county population area doesn’t seem to.  Here we seem to be offered PET scans for cancer screenings, follow ups etc.  

 My mom got a CT scan last year.  No MRI because she was deemed unable to stay still and compliant for the time needed.  NP then compared the CT to an earlier one and an earlier MRI. Confirmed her opinion with the neurologist in the memory area. Pretty much the same things seen as in 2019, which did not get a diagnosis at that time.    She’s got the ischemic micro vascular changes, along with some frontotemporal atrophy.   However it’s not being called frontotemporal dementia.  At least not yet. So officially?  Mild cognitive decline.  

This is probably as specific as it will get, other than to diagnosis the progression through mild, moderate and severe.  

Vitruvius

Just for others information about Semantic Dementia, it is a variant of FTD in which the left frontal lobe shrinks more than the right causing greater difficulty with language and fewer behavioral issues. DW is delusional but not disturbed by these delusions and is usually fairly clam and pleasant. 

The actual review comment was "PET scan indicated severe hypometabolism limited to the left temporal lobe (normal parietal). Review of CT scan shows left greater than right temporal and bifrontal atrophy, marked ventriculomegaly.  Consensus diagnosis is Semantic variant of FTD."

BTW Medicare paid for the PET scan. Others have stated it didn't for them. It may have been the way the neurologist requested or coded it so it might be worth asking about this. 

Caring4two

There are two types of PET scans. One measures sugar metabolism in the brain. The other type is called an amyloid PET. It measures the amount of amyloid in the brain. Used primarily at major medical centers. Neither takes as long as a MRI. The regular PET scan is used to identify damage in the frontal lobes thus maybe an FTLD (frontal temporal lobe dementia) diagnosis. The other one looks more at the amyloid deposits thus maybe a diagnosis of Alzheimer’s. 

But these are not the only causes of dementia. Ischemic, microvascular issues (old term hardening of the arteries) has a dementia path all its own. Also TDP 43 pathology and hippocampus sclerosis. Each does damage to the brain resulting in dementia of some sort. 

My husband (died 5 years ago) had a combination of all the above. Brain autopsy was very interesting. I didn’t know how sick he really was. He was treated with the Exelon patch and Namenda. Later Depakote sprinkles were added to treat seizures, Seroquel for behaviors and Trazadone for sleep.

He was part of a research program so we could help learn how to cure this awful disease.

Medicare and our secondary insurance covered all the costs.