by DR. CORY S. FAWCETT
Most everyone is familiar with A. A. Milne’s characters from The House on Pooh Corner. Eeyore is always down and depressed, moves and talks very slowly, thinks everything is bad and getting worse, and drags everyone down with him. Tigger, on the other hand, is always the life of the party, he is constantly smiling, moving and talking rapidly, dancing and jumping and bringing everyone’s attitude up a notch. Tigger is fun, fun, fun, fun, fun. If you asked each of your office staff which one of these two characters best describes you, what would they say? Is that the answer you want to hear?
How Do You Evaluate Memory Loss?
When an individual begins to show signs of memory loss, a physician’s greatest challenge is often discovering the underlying cause of symptoms. Behavioral evaluations (including self-report questionnaires such as MoCA and MMSE, effort-based computerized testing, and psychological evaluations) and laboratory tests (such as APOE genotyping and biochemical labs such as blood, urine, and CSF analysis) can be useful in developing a diagnosis in cases of advanced symptom presentation1. But how useful are these tools in assessing cases of early memory loss? Are they capable of detecting dementia early, before disease advancement, so that the physician has the opportunity to implement a successful treatment intervention?