Tests for MCI

More and more we are learning that the earlier LBD is identified, the better it can be treated. Then patients, families and physicians know avoiding Lewy-dangerous drugs, emphasizing a healthy lifestyle and focusing on lowering stress decreases symptoms. A diagnosis of mild cognitive impairment (MCI) is a reminder that these changes are also important dementia prevention tactics.

The research community has begun looking at neurological disorders much sooner too. Their challenge is to find signs of a disorder early enough to stop or at least decrease its progress medically. So far, they haven’t been very successful but they are getting closer. One thing they have done is to develop ways to identify MCI early on and even to tell the difference between the AD type (amnestic MCI or MCI-AD) and the LB type (non-amnestic MCI or MCI-LB).

In our 4/19/13 blog, I reported on a fairly new MRI test is now available to help physicians differentiate between several types of dementia, even at the mild cognitive impairment (MCI) level. Called the STructural Abnormality iNDex test (STAND) test, it provides a diagnosis similar to that of a highly skilled behavioral neurology specialist practicing in a large referral medical center. Thus a physician who sees only a few people with LBD a year can still diagnosis it as well as a neurologist who sees many such patients a year, as long as they have access to this test. The problem is that as yet, the STAND test is only available at large teaching or research centers where the specialists already are. Even so, it is worth asking for if you or your spouse/caregiver/family member see evidence of Lewy bodies.

A Lewy-savvy doctor can already identify the likelihood of MCI-LB during an office visit, using a battery of tests including the MMSE, below, and some drawings. The MMSE is given and scored with an emphasis on orientation. Then the patient is asked to a) draw a clock with a designated time showing and b) copy a picture of a cube. (Reference)

The Mini-Mental State Exam (MMSE), which takes only a few minutes in the doctor’s office has a good record of identifying dementia in general. It requires other tests to identify MCI-LB. While the SPECT test below is more accurate, it is not available in a doctor’s office as are the drawing tests above.

The single photon emission computed tomography (SPECT) test is a combination of CT and an injected radioisotope to produce a 3-D image of your brain. It has been found helpful in identifying LBD specifically even in early stages. The process requires special training for administration. While CT scans are available in most hospitals, radioisotopes have a short life and are therefore only available where they are manufactured, i.e., in large medical centers.

For more about LBD, read A Caregiver's Guide to Lewy Body Dementia, by Helen and James Whitworth. Available via our website, LBDtools.com.