Relationship of Initial Symptoms and Differential Dementia Diagnosis in a Memory Disorder Clinic Sample
Objective: The present study examines the consistency of differential dementia diagnoses based on neuropsychological testing. The accuracy rate of clinical diagnoses of various types of dementias, including Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, frontotemporal dementia, mixed dementia, and others, were identified. In addition, other common diagnoses made through neuropsychological testing such as mild cognitive impairment (MCI) and mood disorder were examined as part of the overall analysis. Additionally, initial reported symptoms of dementia were examined to analyze how these first complaints might ultimately relate to a clinical diagnosis. Method: The neuropsychological testing data were catalogued from participants who received neuropsychological testing at the Memory Disorder Clinic, along with initial chief complaint symptoms that were gathered from patients’ electronic medical records. Results: patients diagnosed as within normal limits (WNL) were most often placed in the normal range across the board. For patients diagnosed with a mood disorder or MCI, they were most often in the normal range except for executive functioning, motor processing, and learning and memory in which patients diagnosed with MCI were placed in the borderline range. Patients diagnosed with Alzheimer’s disease or dementia other were most often categorized as impaired in all domains. When examining individual scores, patients diagnosed WNL performed best on majority of tests, though scores were undistinguishable from MCI or mood disorder on some measures. Patients diagnosed with a mood disorder scored significantly worse than those diagnosed WNL on several measures, suggesting a mood disorder has the potential to share neurocognitive patterns with dementia. Overwhelmingly, patients diagnosed with Alzheimer’s disease (AD) performed the worst on individual learning and memory tests, along with exhibiting the largest phonemic/semantic split in the language domain. Secondary symptom complaints of mood disorder was most often associated with clinical diagnosis of a mood disorder, while secondary symptom complaints of behavior changes, psychotic symptoms, gait problems, and tremors were most often associated with a clinical diagnosis of dementia other. Conclusion: This study highlights the importance of being consistent in making clinical diagnoses based on overall patterns of scores and considering initial symptom complaints to ensure differential diagnoses are carried out as accurately as possible.