Skill Checkup: A 71-Year-Old Woman With Signs of Self-Reported Cognitive Impairment and Primarily Short-Term Memory Loss

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 31, 2023

For patients with suspected AD, the American Academy of Neurology recommends structural neuroimaging, via a brain MRI or CT, to detect other potential causes of dementia. This is primarily to identify any lesions that may cause cognitive impairment and rule out potentially treatable causes of progressive cognitive decline, such as chronic subdural hematoma or normal-pressure hydrocephalus.

Measurement of hippocampal volume is not currently used in the diagnosis of AD, though atrophy of the hippocampi on coronal MRI is considered a valid biomarker of neuropathology in clinical research studies.

Brain PET or single-photon emission CT are not recommended in the routine workup of patients with typical presentations of AD but may be used in individuals with atypical presentations or when a form of FTD is suspected.

Amyloid imaging is not recommended in patients with a clear AD diagnosis at the typical age of onset.

Brain imaging in this case rules out other causes of progressive cognitive decline and reveals diffuse cerebral atrophy, supporting a diagnosis of AD.


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