Cognitive Evaluation for Alzheimer’s – What Not to Miss

In this video, PA Jordan Mast zooms out from individual tests to the full clinical context of evaluating cognitive concerns. He reviews the core components of a cognitive workup—from patient- and family-reported symptoms and validated screening tools to labs, neurological and behavioral assessment, family history, and neuropsych testing—and explains why relying on any single data point can lead to missed diagnoses or unnecessary delays.

PA Mast also discusses how to interpret Alzheimer’s-specific testing, including blood-based biomarkers and imaging, alongside other possible contributors to cognitive decline, noting that co-pathology is common and results may not always match clinical presentation. He highlights the value of guideline-informed, tiered evaluation and shared decision-making with patients and care partners and reinforces when referral to neurology or a memory clinic can help clarify next steps.

Key Takeaways:

1. When diagnosing patients with cognitive decline, it is important to consider the whole patient, not just a single assessment.
2. Guidelines and clinical judgment can help PAs create personalized diagnostic paths for our patients.
3. PAs in primary care and specialty care can work together to support patients during the diagnostic process.

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