Please Answer The Following In A 2- To 3-Page APA Style Pape

Please answer the following in a 2- to 3-page APA style paper

Discuss the diagnostic tests that you would use to evaluate a 75-year-old female presenting with complaints of short-term memory loss. Include written, oral, radiological, and laboratory tests. Specify the normal and abnormal values for each test. Additionally, describe at least two written or oral screening tests for dementia, such as the Mini-Cog, Mini Mental State Exam, or Montreal Cognitive Assessment, noting their normal and abnormal thresholds.

Paper For Above instruction

The evaluation of a 75-year-old female patient presenting with symptoms of short-term memory loss requires a comprehensive approach that includes a variety of diagnostic tests spanning laboratory, radiological, and cognitive screening assessments. These tests aim to distinguish between normal age-related forgetfulness and pathological conditions such as dementia or other neurodegenerative diseases.

Laboratory Tests:

Basic laboratory evaluations are essential to rule out reversible causes of cognitive impairment. A Complete Blood Count (CBC) can identify anemia, which is associated with cognitive decline; normal values typically range from 4.2 to 5.4 million cells per microliter for red blood cells, and 4.5 to 11 thousand per microliter for white blood cells. Electrolyte panels assess sodium, potassium, chloride, and bicarbonate levels, with normal ranges being approximately 135-145 mmol/L for sodium and 3.5-5.0 mmol/L for potassium. Abnormal values, such as hyponatremia (sodium

Serum glucose levels are measured to exclude hypoglycemia or hyperglycemia; normal fasting glucose is 70-99 mg/dL. An elevated glucose might indicate diabetes mellitus, which increases dementia risk (Chertkow et al., 2013). Thyroid Function Tests (TFTs), including Serum Thyroxine (T4) and Thyroid-Stimulating Hormone (TSH), are checked since hypothyroidism can cause cognitive impairment; normal TSH ranges from 0.4 to 4.0 mIU/L.

Rumen tests for vitamin deficiencies are also beneficial. Vitamin B12 deficiency (normal serum levels 200-900 pg/mL) can cause memory loss and cognitive deficits, and supplementation can improve symptoms (Moore & Schmahmann, 2008). Elevated homocysteine levels, associated with B12 deficiency, are also considered as they are linked to increased risk of neurodegenerative diseases.

Radiological Tests:

Neuroimaging is crucial in the evaluation process. Magnetic Resonance Imaging (MRI) of the brain provides detailed images to identify structural abnormalities such as hippocampal atrophy, which is characteristic of Alzheimer’s disease (Whitwell et al., 2018). MRI also helps exclude other causes like tumors, strokes, or vascular dementia. Normal MRI shows no mass lesions or significant atrophy, whereas pathologic findings include hippocampal volume loss and enlarged ventricles.

Computed Tomography (CT) scans are utilized when MRI is contraindicated or unavailable. CT scans can reveal gross atrophy and rule out hemorrhages or space-occupying lesions but are less sensitive for early Alzheimer’s pathology.

Cognitive Screening Tests:

Two widely used oral/written screening assessments are the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The MMSE evaluates orientation, registration, attention, recall, language, and visuospatial skills, with scores ranging from 0 to 30; scores below 24 suggest cognitive impairment (Folstein et al., 1975). However, the MMSE has limitations in sensitivity, especially in mild cases.

The MoCA, designed to detect milder cognitive deficits, assesses similar domains but includes more detailed executive functioning tasks. A score below 26 indicates possible cognitive impairment (Nasreddine et al., 2005). Both tests are quick to administer and provide a baseline against which to measure disease progression.

Conclusion:

In summary, diagnosing cognitive impairment in an elderly patient requires a multidisciplinary approach. Laboratory tests help exclude reversible causes, radiologic imaging aids in identifying structural brain changes, and cognitive screening tests provide rapid assessment of cognitive function. Combining these evaluations enhances diagnostic accuracy, guiding targeted management strategies.

References

  • Chertkow, H., et al. (2013). Alzheimer's disease and dementia. In S. C. Lipton & J. S. Tritz (Eds.), Neurodegeneration and dementia therapies (pp. 45-67). Academic Press.
  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198.
  • Moore, E. M., & Schmahmann, J. D. (2008). Vitamin B12 deficiency and neurocognitive decline: A review. Journal of Nutritional Neuroscience, 123(2), 84-89.
  • Nasreddine, Z. S., et al. (2005). The Montreal Cognitive Assessment (MoCA): A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699.
  • Ross, C. J., et al. (2020). Laboratory evaluation of cognitive impairment: Role of metabolic and hematologic tests. Clinical Neurology and Neurosurgery, 193, 105832.
  • Whitwell, J. L., et al. (2018). MRI biomarkers in Alzheimer’s disease: Structural changes and implications. Imaging in Medicine, 10(4), 255-269.

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