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How it Works - Assessment

WHAT HAPPENS WHEN YOU BOOK

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Book an appointment, meet your personal guide for the journey

Meet your care team

Meet your doctor and other professionals who have the time and expertise to make a difference

Manage memory loss

Guided by latest treatment guidelines, we provide comprehensive care — incl. cognitive therapy or medications

Our Assessment PROCESS

Diagnosing dementia and identifying the type is challenging. It requires a combination of tests, specialist medical expertise, as well as input from the patient or caregiver.

To diagnose the cause of the dementia, a specialist doctor must recognize the pattern of the loss of skills and function and determine what a person is still able to do. More recently, additional tests have become available to make a more accurate diagnosis of Alzheimer’s disease or other forms of dementia.

The American Association of Neurologists emphasizes the importance of early diagnosis, as it can help with identifying reversible forms of cognitive impairment and help physicians with monitoring certain conditions.

No single test can diagnose dementia, so our doctors are likely to run a number of tests that can help pinpoint the problem. At Isaac Health, we go through a set of simple steps to get to a diagnosis.

GETTING STARTED

Cognitive and Neuropsychological Tests

We will evaluate your thinking ability. A number of tests measure thinking skills, such as memory, orientation, reasoning and judgment, language skills, and attention. A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms.

Neurological evaluation

Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes and other areas.

Brain scans and laboratory tests

CT or MRI. These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus. PET scans. These can show patterns of brain activity and whether the amyloid or tau protein, hallmarks of Alzheimer’s disease, have been deposited in the brain. Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative diseases.

Diagnosis and treatment planning

Your doctor will discuss your diagnosis with you, as well as the best treatment options available. See our page on treatment for what some potential options may include.

DIFFERENT FORMS OF DEMENTIA

Dementia is an umbrella terms for different conditions affecting the brain and thinking function. There are many different forms of dementia. Here is an overview of some of the most common forms:
Alzheimer’s disease is a progressive neurodegenerative disorder that can result in significant memory impairment. In saying that it is progressive, this means that it will progress overtime. It is mainly caused by the deposition of a protein that builds up both in and around brain cells. This also leads to the formation of plaques around the brain cells that hinder brain activity. In addition to memory loss, patients in the late stages of Alzheimer’s have speech challenges and difficulty registering their surroundings properly.
Vascular dementia is the second most common cause of dementia in the US. As the name suggests, the main cause of vascular dementia is a problem with the blood vessel – either ischemic or hemorrhagic stroke and small vessel ischemic disease – leading to cognitive loss. Stenosis and blockage in brain blood vessels, impaired brain blood circulation, and the brain’s deprivation from vital nutrients could also cause vascular dementia. Alzheimer’s and vascular dementia have many overlapping symptoms, such as cognitive impairment, lack of concentration, difficulty in understanding and communicating, and memory loss. At times, Vascular dementia has a more step-wise course of worsening rather than the more smooth progressive worsening in Alzheimer’s dementia. To prevent vascular dementia, it is important to control vascular risk factors such as high blood pressure, diabetes, high cholesterol and smoking.

Lewy body dementia is a progressive neurodegenerative disease caused by the deposition of abnormal proteins, called alpha-synuclein, in the brain. The alpha-synuclein clusters result in chemical changes in the brain, leading to symptoms such as abnormal movements, difficulty with thought process, and behavior.

Sometimes it is difficult to diagnose this type of dementia since the symptoms overlap with Alzheimer’s and schizophrenia symptoms. The abnormal movements are similar to those in Parkinson disease, and so this is considered a “Parkinson plus” syndrome. Therefore, evaluation by memory disorder and movement disorder specialists can help reach the correct diagnosis.

Frontotemporal dementia affects the frontal and temporal lobes of the brain, which control language, behavior, and personality. Frontotemporal dementia occurs when either one of these lobes shrinks and does not function properly. Symptoms vary according to the damaged area and can include speech problems or behavioral changes, including disinhibited (or uncontrolled) and socially inappropriate behavior, a decline in empathy, and a dramatic change in eating habits. Symptoms of frontotemporal dementia often begin in late 40s and 50s. The exact cause of this kind of dementia is still unknown.
Parkinson’s dementia is diagnosed if patients with Parkinson’s disease experience symptoms of dementia after a year of the onset of their motor difficulties. It is characterized by a loss of memory, trouble with concentrating, and difficulty in thinking and learning due to changes in the neurotransmitters in the brain., including dopamine.
Corticobasal degeneration is a rare progressive brain disease. It is a neurological abnormality caused by the loss of cells in some regions of the brain. People with the disorder tend to lose motor skills in one part of the body, which eventually spreads to the rest of the body. Initial symptoms include rigidity in the limbs, which prevent the patient from voluntarily moving the leg or arm. Over time, behavioral changes develop. The leading cause of this disease is the loss of brain tissue for unknown reasons. Therapies are conducted for each of the symptoms present. Progressive Supranuclear Palsy (PSP) is similar to CBD due to the deterioration of certain areas in the brain, in this case involving the brainstem. It leads to imbalance, slowed movement, trouble in moving eyes, and loss of memory. The first symptom is usually a loss of balance.
Huntington’s is a progressive disease that affects a person’s motor abilities. Huntington’s is a genetic condition that begins with trouble in movement. The onset of dementia affects memory as a person is unable to learn new things and loses their sense of judgment. As the disease progresses further, a person’s intellect declines. Huntington’s disease can also affect people’s mental health. Therapies and medications directed towards symptoms can help. Normal Pressure Hydrocephalus (NPH) is a rare neurological disease that creates trouble in movement and leads to dementia. Due to enlarged ventricles – which are the areas cerebrospinal fluid collects in the brain – this can lead to a triad of difficulty walking with a particular pattern of gait, difficulty controlling urine, and memory changes. Due to its similarity to other neurological disorders, many tests are required to diagnose it, and it often goes undiagnosed. Creutzfeldt-Jakob disease is a rare yet fatal abnormality of the brain that can result in death within a year. Initial symptoms include weak memory, loss of body control, behavioral changes, and blurred vision, which escalate with time and lead to complete loss of memory and blindness. CJD is caused by abnormal forms of proteins in the brain, called “prions.” HIV associated dementia (AIDS dementia) is caused by an infection that spreads across the brain and escalates with the symptoms of dementia. The membranes of the brain swell, causing abnormality in brain functions.

FAQs

Research has shown that almost half of dementia cases are potentially preventable by addressing known risk factors. These include both general health factors, environmental factors, medication, and mental activity. At MyIsaacHealth.com we will guide you to identify the risk factors most relevant to you and help you address them. We will also help you boost cognitive function through memory training and coaching. In isolated cases, certain medications may be indicated to control risk factors or boost cognitive function.

While there is a pipeline of potential medications to slow disease progression, there is currently limited medical treatment available. However, there are a few classes of drugs available to slow cognitive decline. See our section on treatment for details. In addition, cognitive interventions, such as cognitive stimulation therapy, has been shown in many cases to be as effective as medications in slowing cognitive decline, building cognitive reserve, and developing compensatory techniques to support living with cognitive decline.  Finally, addressing risk factors and maintaining a high level of social and brain activity are the great ways to protect yourself.

Our diagnosis and treatment programs are covered by many forms of insurance. See our section on network coverage for details. For pricing without insurance coverage, see our packages

Our care team consists of Neurologists, other brain health doctors, psychologists, speech-language therapists, memory coaches and care coordinators.

While in many cases a family physician or neurologist may have sent you our way, you are welcome to sign up without a referral

If your have health insurance, most of our services will be covered under the terms and conditions of your policy. For prices without health insurance, please see our packages.

Our prevention program is available everywhere. We offer all services in New York, North Carolina, and Florida. Individual services are available also in other States – please feel free to call us for advice.

We chose the name “Isaac Health” because it reminds us of three things:  one of the most influential brains in human history (Sir Isaac Newton), the longest-lived Biblical figure (Isaac, who lived to 180 years old), and that he name “Isaac” literally means “one who laughs or rejoices”. Our name represents what we ultimately hope to achieve for the people we serve through our mission to promote and preserve brain health:  a long, fulfilling life with many moments of genius and joy.

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