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I have read here about how Alzheimers is diagnosed, but I'm still not clear on what the next steps should be. Do I return to the Primary Care doctor who gave tests that diagnosed dementia or go straight to a neurologist? Can either of them diagnose Alzheimers on history and other tests or are brain imaging tests required?

How scary are the brain imaging test? I don't think my LO could handle an MRI without being sedated. Are these imaging tests necessary?

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Moondance,
My cousin has been on disability for arthritis for about 5 years. Now she has another one with this dementia. She's now in AL and doing well there. She's not as disoriented as she was in her home, since others are caring for her. Her OCD seems to have subsided too.

You say that her primary care physician can be the one to follow up with. I like her regular doctor a lot. She was leaning towards Alzheimers based on the tests she gave her. Maybe I'll just make another appointment with her.
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I have in the past, & for patients, gone through a PHD. for the testing & it has become more advanced. I have also used neurologist, primary care physicians, & psychiatrists. I am a R.N. who works with these clients.

I had my husband tested ,even though I knew what was going on, just to get the paper work required for disability. He suffers from Solvent Dementia.
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All of this helps. I've been reading tons of information about dementia and its causes. I guess I need to find a neurologist who accepts Medicare and Medicaid. She has both now and so I hope that means she won't have any out of pocket medical costs, since she has no money to pay them.

Her personality right now is pretty much the same as it was for most of her life. She has significant both long term and short term memory loss. The changes came about slowly over years. I saw it, but just didn't realize what is was.
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If the primary care doctor was the one who did the initial diagnosis, then the next step is to see a neurologist who will confirm dementia and try to find out the cause and type of dementia. I say try to find out because without an autopsy, the cause is often one of comparing scans, elimination of alternatives, and comparing symptoms. In the early stages and with an MRI, my husband was diagnosed with early onset Alzeimer's. After another MRI and a PET three years later, the diagnosis was changed to frontal temporal dementia which fit his symptoms much better.
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Sunny, when were the tests given? What were the tests? If it solely the Mini Mental Status test, there are next steps to take. MRI's and CT scans should be taken as there are some causes of dementia that can be treated. For example a tumor could severely impact brain function and if caught early enough could effectively be treated. Many of those with dementia require sedation just to complete the tests. Also PCP should refer you to a neurologist that specializes in treating elders with dementia. Does the PCP specialize in gerontology? If not, then a change to a geriatric specialist is in order!
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Remember this about diagnosis. The social worker who led an Alzheimzer's group seminar told me that originally the only way to truly diagnose AZ was after death, but that now there is a spinal tap method of diagnosis.

I don't have much experience in the type of physician to handle or recommend the next steps, but others here do and will surely offer suggestions.

I would think twice about the brain imaging tests and/or an MRI. Perhaps you might even want to contact someone at the Alzheimer's Assn. to get their opinion.
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