How we diagnose dementias


Integrated Interview:

One of the most important aspects of a highly detailed interview is the evaluation of a client as a multi-faceted individual where genetic and family histories are taken into account; a very thorough questionnaire filled-out for this purpose includes questions on hormones and their effects on the client.

A special topic is DIET. There are numerous studies documenting the relationship between diet and brain disorders as well as mental health disorders; this cannot be overlooked. Use of the Mediterranean diet, the Chinese-Ayurveda diet or other diets can be recommended. Alzeimer’s disease [AD] and other neurodegenerative diseases have associations with cholesterol metabolism.

The relationship between pesticides and neurodegenerative disorders, like AD and Parkinson´s disease, is being established. Prior to the interview we ask that pesticide exposure be discussed with the elders of the family and an exposure chart drawn-up, especially when there’s a history of rural dwelling.

Neurological Exam:

A complete Neurological exam is necessary in many cases, but there are individuals with epileptic syndromes and hormonal disorders where consults can be done by video-audio computer systems not requiring face-to-face encounters. Hormone laboratory studies are of great importance in these cases.

Cognitive Evaluation:

Neuropsychological testing is the gold standard for assessing cognitive problems and is done by a specially trained Neuropsychologist.

In our laboratory, we perform “patient-directed mental status testing” that can be described as snippets of many known formal cognitive/IQ tests that probe varied areas of brain function not tested through the usual neurological physical exam; this is where the Behavioral Neurologist has expertise compared to a general neurologist.


Brain scans including MRI’s with special cuts, PET and SPECT with special tracers.


Treatable causes of dementias can be diagnosed in this manner. Biomarkers for Alzheimer’s disease, and some other neurodegenerative diseases, have been found but are under scrutiny at this time.

Treatment options:

  • Rehabilitation: cognitive rehab and language rehab are an integral area of very beneficial treatment arrangments, customized for each individual client.
    Highly trained Occupational therapists, Speech-Language therapists, and Neuropsychologists will provide a tightly woven program based on formal assessments of the individual.
  • Preventative: based on each client’s family history, personal Neurological history, hormone history, pesticide history, and diet. Here the goal is to keep from getting a disease.
  • Symptomatic: specific for each symptom after the disease starts. The goal is optimal relief with minimal side-effects.
    Outside of the cholinesterase-inhibitors and a glutamate antagonist, neither Alzheimer’s disease, diffuse [cortical] Lewy body degeneration, frontal-temororal lobe degeneraration [FTLD] or vascular/multi-infarct dementia [MID] have specific treatments, yet, although genetic mutation-geared therapies and vaccines are already undergoing research.
    -Hyper-dosing can be used in a few appropriate instances with sometimes superlative results.
  • Diet is of utmost importance.

For more information, please visit my website or send me an e-mail at

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