Dementia

Dementia is an umbrella term that describes problems with memory, communication, reasoning, and other cognitive tasks. It can have many causes including Alzheimer’s disease, which is the most common.

Suspecting that you or a loved one may be experiencing memory loss or showing signs of cognitive impairment can be frightening. Our specialized memory disorders experts help you navigate each step of the process, from evaluation to treatment. 

Your First Appointment

Our extended appointment times allow us to really get to know you.

• A memory specialist will ask questions about you or your loved one’s medical history.
• A standard neurological exam will help us learn more about how well the nerves, reflexes, and senses are functioning.
• After that, we’ll administer a brief cognitive evaluation. This is a series of simple questions and exercises that help us evaluate capabilities and problem areas.
• Finally, your memory specialist will spend time talking with you about next steps and treatment options.

You can expect to spend a total of two or three hours with our specialists. Before you leave, we’ll make plans to follow-up with you or your loved one every three to six months.

Unfortunately, there is no cure for many types of cognitive impairments, including dementia and Alzheimer’s disease. However, our memory specialists work closely with speech language pathologists, occupational therapists, neuropsychologists, and physical therapists to administer available treatments and to improve your or your loved one’s quality of life.

Medications
Cholinesterase inhibitors and memantine (Namenda) help improve cognitive abilities. Before prescribing, we’ll review all of your or your loved one's existing medications, identify any problems or side effects, and help you decide whether medication is the right choice.

Physical and Occupational Therapy 
Specialized therapists aim to promote health and wellness, increase strength, prevent falls, and enable you or your loved one to maintain as much independence as possible.

Speech Therapy and Communication Support
Speech language pathologists focus on using each person’s strengths and reducing barriers in order to promote successful communication. We problem-solve with you and your family to provide practical, functional, and personalized strategies to overcome difficult situations. We also offer a specialized eight-week program that helps you address communication breakdowns and memory issues, social isolation, or difficulty with conversations. We provide individual and group therapy for the person with cognitive impairment, and we also provide group education and support for caregivers. 

Environmental Changes
Customizing a living environment to be safe for people with memory problems is important. We help guide you through what changes might be necessary, such as adding guide rails and removing excess furniture.

Exercise and Nutrition
An integral part of our mission is wellness. Staying active and eating well may become more challenging for people with memory disorders. We help you or your loved one incorporate behaviors and routines to promote restful sleep, prevent excess weight gain, avoid constipation, and stay hydrated.

Although uncommon, your memory specialist may request some additional tests to rule out other conditions that are rare but can cause cognitive symptoms that are similar to dementia or Alzheimer’s disease.

Imaging
MRI or CT scans create high-quality images of the brain and detect abnormalities. These tests take about 30 to 60 minutes and are virtually painless.

Spinal Fluid Test
In some cases, analyzing cerebrospinal fluid (CSF) can identify whether a person has Alzheimer's disease before symptoms appear. This is performed most commonly through a spinal tap (also known as a lumbar puncture) -- a procedure in which your doctor inserts a needle into your lower back to collect a sample of CSF. You will feel some discomfort. The procedure takes about 30 to 60 minutes. 

Neuropsychological Testing
If a brief cognitive assessment doesn’t provide all of the information your memory specialist needs, he or she may request more in-depth neuropsychological testing to identify the extent of any impairment.

Compassionate Care and Family Support
Our memory experts will provide a sound diagnosis, establish a personalized treatment plan, and patiently answer all your questions. We treat the full spectrum of cognitive impairments, including the behavioral, emotional, and physical aspects of memory disorders. Since there is no cure for dementia or Alzheimer’s disease, developing a support network is essential. The Duke Dementia Family Support Program is a comprehensive resource to help you cope, make elder care decisions, and support your loved one through what can be a very difficult time.

Access to Breakthrough Research
Our researchers are known for their work studying the family history related to Alzheimer’s disease and similar disorders. We discovered the “risk gene” -- apolipoprotein E -- the first gene variation found to increase the risk of developing Alzheimer’s. You or your loved one may be eligible to participate in our clinical trials, which offer access to novel therapies, including possible disease-modifying therapies or medications that affect behavioral symptoms. You may also have the opportunity to participate in research studies to help us learn more about the root cause of Alzheimer’s disease and related dementias -- your contribution to a cure. 

Social Work Services
Our social workers are available to meet with you and provide resources such as patient/family educational materials and to share information about support groups for patients, caregivers, and families. Our social workers help patients and families cope and adjust to memory disorder diagnoses. 

Team Approach
Because there are many causes of memory loss, you and your loved one will have access to experts in neurology, geriatric psychiatry, geriatric medicine, neuropsychology, and social work.