What Does My MRI Scan Report Indicate?
There is no such thing as a typical, classic, or DIAGNOSTIC imaging study that reveals ALZHEIMER'S DISEASE (AD). In other words, there is no MRI picture that can make such a diagnosis nor can it make a diagnosis of EARLY ALZHEIMER's disease. The diagnosis of Alzheimer's can only be made clinically which means that a neurologist should evaluate you by taking a very good history, do appropriate neurological examination, and then, UPON SUFFICIENT SUSPICION the neurologist will order appropriate blood work AND imaging studies.
However, the results of the imaging study are NEVER diagnostic of AD. Chronic vessel ischemic disease and global volume loss are changes that commonly occur and are seen on MRI studies due to nothing more than aging. They do not necessarily represent dementing illnesses although anybody who is "normal" in their cognitive abilities can become abnormal at any time. And again, that is why the diagnosis MUST BE one made in the company of CLINICAL INFORMATION gathered by a competent professional who knows what to look for and how to interpret test results.
Simply based upon the fact that you are writing this question and posting it to this site and given the sentence construction, vocabulary words chosen, ability to COPY information appropriately, and show the concern you show tells me that your cognitive faculties are quite intact. If there are things that a bit off that may be true.....there is a margin of error we allow for people who are older than 60-65 years old to have in terms of forgetfulness which still keeps them within normal ranges. I think that for 78 you are showing VERY GOOD abilities by virtue of what you've written.
The pneumatization of the paranasal is of ZERO relevance or meaning when it comes to brain function and should not concern you or your doctor in the least. Radiologists are obliged to report EVERYTHING they see on a scan even though much of what they see and much of what they report turns out to be normal. The definition of sinus pneumatization is the following:
"an enlargement of the maxillary sinus, usually as part of the aging process and as a result of the loss of maxillary teeth."
Therefore, as I said earlier this finding on a scan is something that is merely reported and bears no relevance to the question of dementia. As you can probably guess it also has little or nothing to do with "frequent" sinus infections, hearing loss (another factor of aging more than anything), or difficulties with wearing a hearing aid on one side or the other (need to check with an ENT specialist as to why that's happening).
In conclusion, your MRI report is not diagnostic of AD. It may only be SUPPORTIVE of a dementing process if a qualified and trained doctor makes a CLINICAL diagnosis of dementia but my strong advice is that you get that sort of opinion from a neurologist. There are margins of error in memory and thinking that are considered normal and it should be more the call of a neurologist to decide if that's the case or not as opposed to a general doctor if you are truly concerned for such a problem. The findings you mention could as easily be considered NORMAL in a person of your age. On the other hand they could also be findings associated with other risk factors that may be in play such as diabetes, hypertension, high cholesterol (hypercholesterolemia), smoking, cirrhosis of the liver, chronic kidney disease or failure, and other metabolic issues best looked at through laboratory and historical data gathering.
Sinus pneumatization is of no relevance to either your questions on AD, small vessel ischemic disease, or volume loss of the brain. It is also of no relevance to hearing aid difficulties, hearing losses, or "frequent" sinus infections unless the portals of entry for these infections would happen to be through badly sealed or healed root canals done or spaces left by any teeth you may have lost from the upper mandibular region.
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