With any progressive neurologic illness, neurological disease process like Alzheimer's dementia, which is one of the most common that we would see in clinic, the most salient disturbance is memory. The reason why people come in is because that is such a huge concern for them and their family members. "Mom is starting to slip up, or Dad is having a harder time completing some tasks, he is leaving things lying around the house. We recent found him maybe wandering and he seemed a little lost and confused."
Now, it's not central to the temporal lobe or the frontal lobe, or any lobe specifically, but when you look at imaging — and this is where imaging becomes very, very helpful in terms of diagnosing Alzheimer's disease, or at least in terms of being a very important piece of that diagnosis — you see a lot of cortical degeneration.
Now, our brain is generally eight pounds, more or less, and what you see on imaging is what would be in laymen terms of shrinking, this degeneration. When you see this degenerative process happening, people tend to think perhaps maybe this is progressive. Neuropsych testing is very helpful for that because we take a patient at that point in time and we perform a series of tasks to determine what level of functionality they're at, how their memory is doing, etc. Then, over time, it may be six months, one year, two years or five years, we can reassess that patient with serial imaging as well to see if their memory declines in tandem with neuroimaging that shows more and more degeneration over time.
