Alzheimer's Second Opinion

Provided by Mark Goodman, Ph.D., M.A., Behavioral Medicine/Neuropsychologist with extensive training, research, experience and New Jersey license Part II oral examination in Geriatric Neuropsychology Dementia Assessment. Alzheimer's Dementia Second Opinion Services provided exclusively from Dr. Goodman to patients or family members of individuals diagnosed with Alzheimer's and/or other non-specific dementias.

Over and over again in my practice, I have found that people have been misdiagnosed with Alzheimer's Disease.  Frequently, more than 80% of the time, I have found they have medical conditions which can be easily treated and result in remarkable improvement in their mental/memory function.  If you (or someone you know) are interested in a professional consultation evaluation, I may be contacted by telephone to arrange for an appointment by telephone, in my office, or your home.

 
Consultation
Diagnosis
Helpful Information
Biography
Results History
Consultation Service and Contact Information
Published Research

Consultation

Telephone (via mail and fax) diagnostic consultation or face-to-face diagnostic consultation with me functioning as a liaison to and between your family and in collaboration with your local treating physician. This is provided by a licensed clinical expert originally trained as a research scientist and whose dementia work is based upon my training, experience and results of my own published studies on risk factors for identifying reversible dementias misdiagnosed as Dementia of the Alzheimer's Type. Essentially, I will review the extensive decade long medical records of the patient mailed to me to provide information unique to that patient on identification of causes of possible misdiagnosed Alzheimer's dementia and other reversible dementias. Dementia of the Alzheimer's Type is a "terminal" diagnosis and should not be conferred cavalierly upon any patient, nor should it be conferred without exhaustive hours of reviewing patient medical history and results of tests including neurocognitive assessment (by someone trained and experienced in differential diagnosis of dementias) and examining laboratory blood/urine chemistry evidence which may depict a profile consistent with a reversible, treatable, or non-progressive memory loss.

Diagnosis

The American Psychiatric Association's Diagnostic and Statistical Manual on Mental Disorders, Fourth Edition (DSM IV) emphasizes that "Dementia of the Alzheimer's Type is currently a diagnosis of exclusion and other causes for the cognitive deficits must first be ruled out" (p.138-DSM IV). The DSM IV (p.136-139) also notes the necessity of non-invasive "neuropsychological testing" in defining cognitive symptoms and patterns of deficits (such as vitamin B12 deficiency) allowing the Alzheimer's diagnosis to be ruled-out/excluded. An additional risk factor contributing to misdiagnosed Alzheimer's is the considerable disagreement in the medical community as to the exact signs/symptoms and definition of what is Alzheimer's. Microscopic brain examination in autopsy often is inconclusive as to the correct diagnosis. This poor diagnostic accuracy is in part responsible for the statistical disagreement in the percentage of individuals with Alzheimer's. Furthermore, without exhaustive time spent on differential diagnosis "ruling-out"/excluding other contributing disorders to increase diagnostic accuracy, how can Alzheimer's researchers searching for anti-Alzheimer's medications even be sure their test subjects have Alzheimer's?

Helpful Information

Regardless whether or not my services are utilized, one should attempt to follow the American Academy of Neurology Guidelines for dementia workups. However, in the course of my research I had developed a more comprehensive list of laboratory tests and non-invasive specific neurobehavioral/neuropsychological tests which have rapidly allowed me to identify mis-diagnosed Alzheimer's and other reversible dementias.

 
One such test I've created non-invasively identifies mis-diagnosed Alzheimer's due to vitamin B12 deficiency despite normal blood levels of vitamin B12 (published).

 

Another rapid non-invasive test I developed has demonstrated superior ability to identify geriatric Normal Pressure Hydrocephalus mis-diagnosed as Alzheimer's but with data indicating a rapid and easily treatable form of dementia for those as old as 93 years of age (published).

 

These additional specific and select customized lab tests/neurobehavioral tests are available from me by consultation.

Biography

I am one of approximately 12 individuals in the United States who have earned an accredited Ph.D. in Behavioral Medicine (with specialization in medical neuropsychology) from the University of Maryland, Baltimore. Behavioral Medicine is a new interdisciplinary specialty combining cross training in functional brain behavior assessment, behavioral psychology, neurosciences, physiology and medicine. My externship and clinical internship/residency were completed at Johns Hopkins and The Union Memorial Hospitals in Baltimore, Maryland. I was the Principal Investigator conducting grant funded clinical research on diagnostic neurobehavioral risk factors at the time of data collection for my published research on "Neuropsych methods to identify treatable/reversible dementias misdiagnosed as Alzheimer's." I was also Attending Clinician and Faculty Preceptor on the Neurology/Psychiatry monthly rotation for Internal Medicine and Family Practice Residents with clinical consultation/liaison assignments to cardiology, open-heart, cardiac intensive care unit, geriatrics and general medicine in-patient services. Currently, I am fully licensed in New Jersey, U.S.A. and have passed a specialty exam in geriatric neuropsych differential diagnostics. I provide out-patient dementia diagnostic consulting and am continuing clinically relevant research and mentor/precept physicians clinically and in medical research.

Results History

My research both published and unpublished, and clinical geriatric experience has allowed me to rapidly recognize patients referred to me with Alzheimer's suspected or diagnosed by well meaning physicians not extensively trained/experienced in neurocognitive/neurobehavioral identification of Dementia of the Alzheimer's Type as instead having treatable/reversible dementia. In 1997, I reversed incorrect Alzheimer's diagnosis in 81% of patients referred to me. In 70% of these 81% of patients, impaired memory symptoms were reversed. In cases where I couldn’t identify any treatable/reversible causes (for example, dementia due to multiple small strokes) I was able to rapidly determine this and inform the patient and family it was not Alzheimer's. Although not reversible, it came as a relief to the family that they were not at greater risk for Alzheimer's and the condition was not progressive with medical management from their primary care physician.

I cannot/do not reverse true/valid Alzheimer's Dementia.  No one can!
However, I can assist in identifying subtle, rare or often overlooked treatable/reversible causes of memory loss/dementia frequently misdiagnosed as Dementia of the Alzheimer's Type.

Consultation Service and Contact Information

Fee:

$125 per hour by telephone (or face-to-face in my office at $250 per hour) commencing with conclusion of no-cost 15 minute initial phone consultation determining if I can provide assistance, identify a plan or appropriate referral.

My northern New Jersey office hours for face-to-face diagnostic assessments are Sundays, which makes it easier for working family caregivers to bring the patient in for proper diagnostic assessment and also immediate medical treatment from a Board Certified physician with whom I practice on Sundays.

Hours:

At your convenience scheduled by appointment within one week of request made during initial 15 minute no-cost consultation available Tuesday, Thursday and Saturday mornings 9:00 a.m. to 10:00 a.m. and Tuesday and Thursday evenings 7:00 p.m. to 7:30 p.m. eastern time.

Consults:

  1. Neurocognitive diagnostic assessment by phone with a designated family member (and with patient) takes 30 to 90 minutes after I perform a thorough chart review ruling-out possible causes for memory loss.

  2. Immediate verbal feedback with as much time as is necessary to respond to all questions without feeling rushed.

  3. Feedback with treatment suggestions to your local treating physician if desired.

  4. Consultation by telephone or at my northern New Jersey office with treatment is possible or I can travel to the patient if proper authorizations are pre-arranged.

Contact Information By Phone Only:

(Email is not available for this Website)

Dr. Mark Goodman
Phone:  (973) 731-4521
Initial Phone Contact Hours:
Tuesday, Thursday and Saturday mornings 9:00AM to 10:00AM eastern time
Evenings (Tuesday and Thursday) 7:00PM to 7:30PM eastern time

 

Published Research

  1. Are U.S. Lower Normal B12 Limits Too Low?
  2. An Interview: Reversible dementia misdiagnosed as Alzheimer's due to non-anemic vitamin B12 deficiency detected by neurocognitive assessment.
  3. Dementia Reversal in Post-shunt Normal Pressure Hydrocephalus Predicted by Neuropsychological Assessment