Alzheimer's Disease: Is It Time to See a Neurologist?

April 18, 2022

A diagnosis of Alzheimer’s disease can be devastating for both patient and loved ones alike. Sometimes, even getting an accurate diagnosis in the first place is difficult. The first step on an often-arduous journey is finding the right doctor to begin the process of diagnosis, treatment and management.

But before we delve in, let’s begin with some words of hope: Alzheimer’s disease is an area of robust research and development. Every day, doctors and scientists are discovering more about treatments to reduce the symptoms of Alzheimer’s and, ultimately, find a cure. In fact, a recent study showed that light therapy reversed the progression of Alzheimer’s in mice!

Which Doctors Treat Alzheimer’s Disease?

There is a dizzying host of medical professionals who deal with Alzheimer’s disease in one respect or another. Finding the “right” one once symptoms of Alzheimer’s appear can be confusing and overwhelming. Often, treatment from a combination of specialists will proffer the best overall care. Let’s break it down:

• Your primary care doctor. This is often where people begin, because a patient’s primary care provider (PCP) knows them, their medical history and baseline, and the patient in turn knows their doctor. There’s a sense of mutual trust and familiarity right from the start. However, while a PCP may be the one to initially suspect a patient has Alzheimer’s (based primarily on subjective evidence), most are not specialists in the brain and memory issues surrounding Alzheimer’s and will likely refer a patient to someone who is.
• Neurologist. A neurologist is a physician specializing in diseases of the brain, spinal cord and nervous system, including Alzheimer’s, Parkinson’s disease, epilepsy, and stroke. This specialist has a doctorate in medicine and has completed a residency in neurology. Bear in mind, not all neurologists are trained in diseases that affect the elderly, so it’s important to find a neurologist experienced with dementia.
• Geriatrician. This is a medical doctor who is board certified in geriatric medicine and who specializes in the treatment of conditions prevalent in the elderly, predominantly the “super seniors” aged 85 and above. It is important to note that geriatricians are not necessarily specialists in the brain or nervous system, though some are more experienced with dementia than others.
• Geriatric psychiatrist. A so-called “superspecialist” in the arena of Alzheimer’s and dementia, a   geriatric psychiatrist concentrates on the mental and emotional concerns of older adults. They have earned a doctorate in medicine and completed a residency in psychiatry with a focus on geriatrics. They can conduct comprehensive memory, mood, sleep, and cognitive evaluations as well as assess life events and circumstances that may affect memory. What’s more, a geriatric psychiatrist can prescribe medications that treat the cognitive and behavioral symptoms of Alzheimer’s.
• Geropsychologist. Another superspecialist, this professional has expertise in the mental and emotional well-being of senior adults. They can conduct psychological testing and offer psychotherapy, or “talk therapy,” related to coping strategies, caregiving and behavior management of the symptoms of Alzheimer’s. They have earned a doctorate in psychology and can perform various evaluative tests, but they are not authorized to prescribe medications. Another more specialized level of psychologist is a neuropsychologist, typically a PhD, who specializes in the relationship between brain systems and behaviors; this person may or may not have experience treating older adults.
• Behavioral neurologist. Yet another superspecialist, this doctor is proficient in cognitive problems such as memory loss and can detect behavioral issues resulting from stroke or infection. They can also run thorough neurological and cognitive exams.

Is a Neurologist the Best Choice?

Considering the myriad specialists in the treatment of Alzheimer’s, a good “best bet” after a visit with one’s primary care doctor is a neurologist versed in Alzheimer’s and conditions affecting the elderly.

A neurologist will have the knowledge, training and experience with the inner workings of the brain required to either begin a care plan or intelligently refer a patient to another qualified expert in this
area – perhaps even one of the aforementioned “superspecialists.”

What’s exciting is that neurology is the field in which the most leading research on brain disorders is occurring. Doctors in this field will likely be the most informed on new findings, medications, trials, and studies.

Which Other Specialists Might Be Helpful?

Because Alzheimer’s is an all-encompassing disease that affects the overall health and well-being of the patient and often their family as well, the services of other professionals who are not medical doctors can also be beneficial. These include dementia social workers, nurses, geriatric nurse practitioners, and supportive senior care providers and/or communities.

How Can I Find the Right Doctor and Resources?

Word of mouth is still one of the most reliable sources of trusted information, so don’t hesitate to ask among friends and associates whose loved ones have been diagnosed with Alzheimer’s disease for recommendations on doctors, services, programs, etc. Other good referral sources are your loved one’s primary care doctor, your local medical center, nearby memory care facilities, “Local Resources” at alz.org, and a careful Internet search of neurologists in your area (beware of paid or sponsored ads and be sure to read reviews).

You may also wish to consult the Alzheimer’s Disease Centers (ADCs), sponsored by the National institute on Aging. The Alzheimer’s Association has a 24/7 helpline that may be of service on several fronts. For an idea of what to look for in a top-notch doctor across various specialties, check out the Mayo Clinic’s expertise and rankings.

How Should I Prepare for My Appointment?

• Be patient. Don’t be surprised if it takes several days or even weeks to get an appointment with a neurologist or other specialist. It may also take time to receive test results.
• Verify credentials and coverage. Ensure ahead of time that the doctor(s) you have sought is licensed and certified and that your loved one’s insurance plan will cover various visits and procedures.
• Keep a journal. Begin logging any changes in your loved one’s health, including memory, mood and behaviors. Bring this log to all physician appointments.
• Bring a list of current medications. Come prepared with a list of any current medications and dosages as well, including any vitamins and supplements.
• Write down your questions. It is all too easy to forget important questions when you’re consulting with your own or a loved one’s doctor. Make a list of your questions in advance, record (if allowed) or write down the answers you receive, preferably at the time of the appointment, and be sure to answer any questions you are asked as thoroughly and honestly as possible.
• Expect to be evaluated. Your loved one’s doctor may assess such things as their physical and mental health history, their current mental status, eye and other sensory systems, fine and gross motor skills, tendon reflexes, coordination, gait, and other functions. They may also order blood and urine tests as well as other procedures and/or make recommendations for a specialist.

Memory Care at Barclay Friends

Depending on one’s degree of Alzheimer’s disease or dementia, supportive community living may be an appropriate care choice. Barclay Friends’ dedicated memory care environment adopts a person-centered approach, tailored to each resident’s individual preferences and interests. Residents have the right to participate in decisions about their lives. Staff offer residents choices by “doing with” rather than “doing for.” What’s more, our attending physicians personally know each resident and their unique health situations and can offer referrals to a neurologist or other specialists, if needed.

Discover memory care centered on “doing with,” not “doing for.”
Barclay Friends offers a full continuum of care.