What to Expect

At your visit to Columbia Neurology's Aging and Dementia Practice, you can expect to receive a comprehensive neurological examination from one of our neurologists or nurse practitioners, each of whom offers particular expertise in the diagnosis and treatment of memory impairment and brain-behavior disorders. Your initial examination will include a thorough review of your medical history, including detailed descriptions of cognitive complaints and changes in behavior.

Following your initial examination, your neurologist or nurse practitioner will coordinate any additional evaluations that are required in order to provide you and your family with a complete treatment plan. This additional testing may be arranged the same day (depending on availability) or scheduled separately, and may include:

• Neuropsychological testing to thoroughly assess memory and thinking
• Laboratory analysis - blood (for possible nutritional and vitamin deficiencies, thyroid imbalance, inflammation, or infections)
• Brain structural imaging tests, such as MRI or CT
• Molecular imaging, including amyloid PET imaging
• Brain functional imaging, such as SPECT or metabolic PET
• Biomarker testing of spinal fluid (CSF)
• Vascular tests such as carotid ultrasound or MRA

Genetic Testing

You may be referred to our genetic counselors to review your family history, to discuss your interest and the availability of genetic testing for your condition, and what the results of that genetic test mean for you and your family members. This includes counseling for APOE genotype, important for assessing risk for disease-modifying therapies (Lecanemab and Donanemab).

Social Services

Patients who visit our center may also benefit from the social services offered by our licensed clinical social worker, who is available to meet with patients and families after appointments or at a separate time to provide support, referrals, and guidance on the following:

• Navigating health care systems
• Questions regarding disability
• Referral for legal services
• Home health services
• Late-stage planning, including understanding advanced directives and guidance in the placement process
• Supportive counseling

Treatment

We offer all FDA-approved medications for cognition and behavior, including symptomatic therapy (Donepezil Rivastigmine, galantamine, memantine) and new disease-modifying therapies (Lecanemab and Donanemab).

Research

During your visit, your neurologist or nurse practitioner can discuss the opportunity to participate in both state-of-the-art observational research studies and clinical trials of the most advanced drugs in development.

How to Prepare for Your First Visit

Please bring copies of your medical records to your appointment, including any recent blood test reports, brain CT and/or MRI reports, neuropsychological test reports, compact discs (CDs) of any brain imaging, and a complete list of all current medications.

At your initial visit, your doctor may discuss some preliminary findings. You may also be scheduled for additional diagnostic testing. After completion of these tests, you will be scheduled for a follow-up visit at which time these results and your full, individualized treatment plan will be discussed.

Insurance and Billing

Our center accepts Medicare and most major health insurances. Our staff will assist with verifying our participation with their specific insurance carrier prior to scheduling an appointment.

International Patients

We welcome international patients! Many of our physicians and staff speak both Spanish and English, as well as other languages. Translators are available. You may also wish to contact NewYork-Presbyterian Hospital Global Services at 212-305-4900 or via email at globalservices@nyp.org.