Memory Disorders Center

Alzheimer's disease is a neurological disorder that leads to the death of brain cells, which causes memory loss and cognitive decline, affecting all aspects of brain function. It’s the most common cause of dementia.

Corticobasal degeneration results in nerve cell loss and wasting away (atrophy) of multiple areas of the brain.

Creutzfeldt-Jakob disease (CLD) is a rare, degenerative, fatal brain disorder that progresses rapidly. An abnormal form of a protein in the brain (prion) leads to CLD.

Dementia with Lewy bodies (DLB), also known as Lewy body dementia (LBD), causes a gradual decline in mental function, sometimes with visual hallucinations. DLB may also cause movement problems similar to symptoms of Parkinson's disease.

Frontotemporal dementia (FTD) is a group of brain disorders that happen when damage occurs to the nerve cells in the front (frontal) and side (temporal) lobes of the brain. FTD causes the lobes to shrink.

Huntington's disease causes degeneration in many regions of the brain and spinal cord.

Mild cognitive impairment refers to difficulties with cognitive functions, such as learning, making decisions, and remembering. These impairments are worse than expected for your age, but not severe enough to interfere with normal activities or relationships. Mild cognitive impairment may occur before (be a precursor to) a dementia diagnosis.

Normal pressure hydrocephalus (NPH) results in an overaccumulation of fluid in the chambers of the brain called ventricles. NPH causes symptoms similar to Alzheimer’s disease and Parkinson’s disease.

Progressive supranuclear palsy (PSP) is a rare, complex condition that affects the eye-moving region (supranuclear region) of the brain, causing progressive weakness in certain muscles. It can sometimes cause changes in behavior and thinking.

Vascular dementia (VaD) is the second most common form of dementia after Alzheimer’s disease. Damage to brain tissue, which occurs due to decreased blood flow, causes VaD.

Most patients find their visits to the Memory Disorders Center pleasant, productive, and informative. Our goal is to help you find the cause of your symptoms and to offer you the best available treatments.

The first visit to the Center usually involves a thorough history and physical exam, plenty of face-to-face time with one of our behavioral neurologists, and ample time for questions. The result of that visit is often a plan for further diagnostic testing. Depending on your specific situation, this may include:

• Blood tests
• Cerebrospinal fluid test (CSF)
• State-of-the-art magnetic resonance imaging (MRI) or other brain scanning technologies such as a positron emission tomography (PET) scan

We frequently encourage our new patients to undergo a complete neuropsychological assessment with one of the specialty-trained neuropsychologists on our team during a separate visit. We can schedule this assessment at your convenience.

In addition to this intense initial evaluation, we offer longitudinal care. The neurologist whom you met at your initial visit will remain your "go-to" neurologist for as long as you require care. We learn a lot from our patients by staying in touch with them over the long term.

Medications can help lessen or control some memory and thinking (cognitive) and behavioral symptoms, depending on your specific condition. Medications for treating memory disorders include:

Amyloid reducing agents

The FDA has given accelerated approval for two drugs that may slow the progression of Alzheimer’s disease and are only indicated for people with mild disease:

• Lecanemab (Lequembi®)
• Aducanumab (Aduhelm®)

These drugs target removal of brain amyloid, one of the proteins that build up in the brain of people with Alzheimer’s disease. Before starting these drugs, your doctor will need to confirm the presence of amyloid in your brain. Your doctor will order either an amyloid PET scan or spinal tap.

The long-term effects of lecanemab and aducanumab in people with early Alzheimer’s disease are still being studied.

Learn more about important safety, eligibility, and cost information for lecanemab.

Anti-anxiety medications (anxiolytics)

These medications help to treat anxiety and lessen restlessness. They can also be used to manage muscle twitches (myoclonus) if you have conditions such as corticobasal degeneration or Huntington’s disease.

Antidepressants

We may recommend an antidepressant (usually a selective serotonin reuptake inhibitor, or SSRI) to help with depression and irritability.

Botulinum toxin (Botox®)

Botox can help to control involuntary muscle contractions (dystonia) associated with corticobasal degeneration.

Cholinesterase inhibitors

These drugs may help stop the breakdown of acetylcholine, a chemical in your brain that helps with memory. They may be most effective for reducing symptoms that affect memory and thinking in a mild or moderate form of Alzheimer’s disease or dementia with Lewy bodies (DLB).

Movement disorder treatments

Medications can help to treat involuntary movements associated with Huntington’s disease. These treatments include:

• Deutetrabenazine
• Tetrabenazine

N-methyl D-aspartate (NMDA) receptor antagonists

These drugs prevent excess levels of glutamate (a chemical that carries nerve signals) from harming the brain. This may help delay decline in cognitive ability. NMDA receptor antagonists may be most effective for a moderate to severe form of Alzheimer’s disease or dementia. Memantine is an NMDA receptor antagonist.

People with Alzheimer’s often take a NMDA receptor antagonist along with a cholinesterase inhibitor to better treat their symptoms. For instance, Namzaric® combines memantine and donepezil into one medication.

In addition to medical treatment, our doctors may recommend changes to your diet and lifestyle to help you control your symptoms.

Diet modifications can be particularly helpful if you have dementia. The MIND diet combines the DASH diet (Dietary Approaches to Stop Hypertension) with the Mediterranean diet. The MIND diet recommends eating 10 types of food, including vegetables, berries, nuts, whole grains, fish, beans, and poultry. It also recommends avoiding certain types of food, including butter, cheese, and fried food. Researchers are looking into whether the MIND diet can help to prevent or slow dementia.

Your care team also supports you in making other lifestyle changes that can help reduce your symptoms. Depending on your condition, these changes may include:

• Challenging your brain with activities or hobbies
• Decreasing alcohol consumption
• Getting enough sleep at night
• Managing your blood pressure, cholesterol, diabetes, and problems with heart rhythms, if needed
• Quitting smoking
• Staying active with regular exercise, such as walking
• Staying organized with a calendar or reminders

For some memory disorders, therapy can help with problems with coordination, recall, and speech. Specific therapies we recommend include:

• Cognitive stimulation therapy (CST): If you have mild to moderate dementia, a CST group helps you stay mentally stimulated with activities like cooking and singing
• Occupational therapy: Occupational therapy can help you manage day-to-day tasks
• Physical therapy: Physical therapy can assist you in keeping your ability to move (mobility)
• Reality orientation training: This therapy helps you to remember basic information like the date and your name, possibly with notes or reminders throughout the area where you live
• Reminiscence therapy: This therapy encourages you to talk about events in your life, such as where you grew up or your work. It can be done in groups or one-on-one
• Speech therapy: Speech therapy can help with speaking and swallowing

Though surgery is generally not needed for memory disorders, it can help with certain conditions:

Normal pressure hydrocephalus (NPH): Our doctors can place a tube (shunt) into your brain. The shunt drains the excess fluid into your abdomen, where your body absorbs it. A shunt can help with incontinence and changes in your gait, but doesn’t help with cognitive symptoms

Emotional support from friends, family, and counselors can help you to manage anxiety and fear over your condition. Psychologists, psychiatrists, social workers, and other therapists can all be helpful.

Care for memory disorders goes beyond medical treatments. We encircle you and your family with supportive services to help treat your mind, body, and soul.