Suggest treatment for early stages of dementia
I read your question carefully and I understand your concern.
The first step when suspecting one has dementia, meaning a decline of cognitive functions (memory, speech, judgement etc), is to verify there is indeed such an impairment. That is because evaluating these fields can be subjective and issues such as depression or anxiety may mimic such impairment. For that reason cognitive function is more objectively evaluated through standard neuropsychological tests, sort of questionnaries evaluating different areas of cognition. They are best administered by a neuropsychologist or neurologist.
If tests confirm there is cognitive impairment diagnostic tests regarding the cause are done. Dementia may have different causes. Most common is Alzheimer's disease, followed by stroke, but can also have treatable causes such as tumors, low thyroid function, vitamin B12 deficiency. For that reason routine testing includes first MRI both to rule out tumor or stroke as well as to evaluate involved areas of brain shrinking which can indicate the cause. Apart from MRI, routine blood tests like blood count, glucose, liver and kidney function, electrolytes, thyroid function, vitamin B12, syphilis are done.
After that if diagnosis is clear treatment may be initiated according to the cause which has been concluded.
At times additional tests may be done, like lumbar puncture which is done either when there is doubt about the cause and signs of infection are searched, or may also be done to look for certain proteins like tau or amyloid which concentration is altered (but their measurement is not routine, mainly for research purposes). Brain scanning with SPECT or PET may at times be done to differentiate between some types of dementia, but is not a routine exam, done only in certain centers.
As for the best clinics, in California there is a list of 10 approved centers of excellence for Alzheimer's and other types of dementia, can find the list at this link: http://cadc.cdph.ca.gov/index.html
I remain at your disposal for other questions.
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