Labs can show risk for Cognitive Decline

We’re all hoping to prevent cognitive decline as you age. Below is a comprehensive list of labs your physician can run to see if you have markers known to increase your risk. The reason to run these BEFORE you experience any symptoms is to be able to make changes to improve these markers and therefore improve your overall physical and cognitive health.

Certainly not everyone needs to run every item on the list, talking with your provider should help you choose which makes sense for you, given your personal and family history. I have broken down the labs by categories below.

Basic Metabolic Markers

• Chem 23 (comprehensive profile)

• HgbA1c, Insulin, Fasting blood sugar, GGT

• Lipid Panel (HDL, LDL, VLDL, Total Cholesterol, Ratio). HOMA-Insulin Resistance calculator (requires fasting insulin and fasting glucose)

• Vitamin D-25. copper, sedimentation rate. MMA, B-1, B-6, cobalamine, Ca, Mg

• CRP (or hsCRP), ferritin, IL-6, homocysteine, TNF-α, D-dimer

• Urinalysis with culture if indicated. (In elderly patients, the only symptom of a UTI may be confusion!)

Advanced Lipid Testing

• Apolipoprotein differentiation if lipids are elevated.

Blood Cell Analysis

• CBC with differential and platelets.

Hormone Panels

• TSH/T7, TPO auto-antibody, antithyroglobulin, cortisol, gonadotrophic hormones (Total estrogen, estradiol, testosterone, DHEA). Hypothyroidism and subclinical hypothyroidism nearly doubles risk of cognitive decline.

Genetic Testing

• APO-e

• MTHFR.

Preventive Screening and Specialized Testing to be done in office or requiring referral

• Cognitive Screening (CPC*) and Instruments*: MIS, Mini-Cog, Short IQCODE , AD8, GPCOG *See Resources

• Bone density screens for women. Colonoscopy, Calcium score, and EKG as indicated

• Other testing… Stool analysis CDSA, GI Map, Elisa testing, ASI, IL-1Beta. Methylation, Plasma AA (esp: Met/Homocysteine).

Again, this list is comprehensive and you should talk to your doctor to see which tests are most appro