Office-Based Assessment of Memory
Loss and Cognitive Impairment
David Hagedorn, Ph.D., BCN
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which are performed outside of primary
care clinics, yield some objective
biomarkers, and detailed looks at cortical
and subcortical brain structures. But fMRI
and SPECT are invasive and costly.
Traditional EEG testing is also difficult and
time consuming, requiring a skilled
technician to process the data. By 2030, the
global cost of Alzheimer’s and other
neurodegenerative disorders is projected to
climb to $1.1 trillion (Source: http://
www.mybraintest.org/memory-testassessment-products/?0715). The
importance of easy-to-use, office-based
screening tools is increasing as the costs
associated with neurodegenerative
disorders are on the rise.
In a medical system that typically does
not afford ample time for exhaustive
interviews and testing, physicians need a
very fast, low-cost, objective, and sensitive
test. Currently, there is only one office based
solution that fits these criteria –
electrophysiology assessment and analysis.
Since electrophysiology objectively maps
patients’ brains, it allows physicians to
narrowly identify activity within specific
areas, such as hypofunction in the
dorsolateral prefrontal cortex that is
associated with dementia. Patients can
witness objective evidence of their
conditions, and track their progress during
different treatments.
Evoke Neuroscience was formed in 2009
by research scientists, clinicians, medical
doctors, and business professionals
dedicated to developing and delivering
the most important advances in cognitive
brain science and neurofeedback. Its three
founders have more than sixty combined
hysicians are charged with
determining causes of patients’
complaints and detecting
potential diseases early in order to
maximize convalescence. In cases
of neurodegenerative conditions, however,
speedy testing for is hindered by lengthy
neuropsychological screening tests such as
the Mini-Mental Status Exam and Blessed
Dementia Scale. Even when time is
available, these tests lack requisite
sensitivity for preclinical memory disorder
detection. Also, they don’t lend much
support for the discrimination of dementia
causes from other potentially reversible
conditions, such as depression, thyroid
disorder, and infection – all of which can
mimic neurodegenerative dementia.
Alzheimer’s disease is the most feared
neurodegenerative condition, accounting for
the majority of late life dementias (60-80%).
Multiple other memory and cognitive
disorders – including frontotemporal lobar
degeneration, vascular dementia, dementia
with Lewy bodies, Parkinson’s disease
dementia, and Creutzfeldt-Jakob disease –
are also considered in screening evaluations
of patients in the course of diagnosing and
determining treatment. The use of effortbased tests and questionnaires, when
applied optimally, can identify more severe
memory impairments, but they often fall
short in the detection of disease
presentations when early on, or if they’re