welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Wednesday, September 14, 2022

my story revisited #150-get the diagnosis right


in 2022 you should be able to accurately diagnosis alzheimers disease in patients with memory loss
i have had all of these tests so i feel like my diagnosis of mci due to alzheimers is accurate

i had a thorough neurological history and exam lots of tests like labs spinal taps genetic tests mris neuropsychological exams amyvid pet scans and tau pet scans
it all says i have alzheimers disease as my diagnosis
its as accurate as it can be in 2022

note i also have had the alzheimers blood test done for amyloid and tau but have not seen the results since it was done in research studies
i presume that its positive since im still in the biogen aduhelm study called the embark study

note yesterday at ucla i got my #21 infusion of aduhelm or aducanumab
i previously had 18 infusions of the placebo

there are several other causes of dementia besides alzheimers disease
alzheimers is the most common one

back when i wrote the blog below i had given a presentation on the other dementia causes for a two day seminar for memory care workers

its important to get the diagnosis correct since the management of these different dementias are different

the blog below lists the most common other dementias
to those who were at my alzheimers presentation yesterday
here are the links to the online quizzes i mentioned

21 question questionnaire

i got asked this question twice yesterday
is alzheimers disease dementia
is dementia alzheimers disease

the answer is yes and no

dementia is a general term that is loss of memory that interferes
with your daily life
it has several causes

one of them is alzheimers disease
the most common type of dementia
it makes up 60-80% of all cases of dementia
inside the brain beta amyloid and tau protein accumulation occurs
that results in brain cell damage and death

vascular dementia
is the second most common cause of dementia
it represents 10% of all cases
commonly its caused by strokes or ministrokes
also on brain imaging vascular changes can be seen
sometimes these are silent changes
the symptoms can vary based on the area of the brain affected

dementia with lewy bodies
not as common as the other two above
its is caused by an accumulation of proteins in the cortex of the brain
called alpha synuclein
the diagnosis is made  by an experienced doctor like a neurologist
who puts the patients history together to make the diagnosis
final true diagnosis can only be made by autopsy

mixed dementia
it represents a mixture of more than one type of dementia
usually a mixture of alzheimers disease and vascular dementia
lewy body dementia can also be mixed with alzheimers disease
and or vascular dementia
mixed is more common than we realized before

parkinsons disease
it can lead to a progressive dementia
there can be changes caused by the protein alpha synuclein
like in lewy body dementia

frontotemporal dementia
the front lobes and temporal lobes are affected
think front of brain and over temples
they get changes in personality and behavior at a earlier age
they tend to progress faster than alzheimers disease
theres not the microscopic changes you see in the dementias above

creuztfeldt jakobs disease cjd
a very rare disease
a variant found in cattle called mad cow disease can be transferred
to humans
its a rapid progressive disease

normal pressure hydrocephalus
a rare one but its an important one since if its diagnosed
and treated with shunting a person might show marked improvement
there is increased fluid buildup in the brain which can be relieved for
some by removing the fluid by placing a shunt to the brain to drain
the fluid or by removing the fluid by spinal tap

huntingtons disease
a genetic progressive disease

wernicke-korksakoff syndrome
is caused by a severe lack of vitamin b12 or thiamine
commonly caused by alcohol abuse
thiamine is needed by the nerve cells to provide sugar for energy
no thiamine no energy production so brain cells dont work

so in summary
yes alzheimers is the most common cause of dementia
but a patients dementia can be caused by many causes as above

an excellent online reference on dementia is
the alzheimers associations website
so make sure your or your loved ones memory loss is evaluated completely
consider walking in your local alzheimers walk

you can join and or donate to our 
organicgreendoctor walk team for the santa barbara walk to end alzheimers on saturday november 5th

this is our 12th year to do the alzheimers walks

help us find a treatment or cure for this terrible disease

the organicgreen doctor

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