Alzheimer’s Disease Consultations Across Hospitals: Helping a New Doctor Understand Changes and Previous Treatment

When preparing for a memory clinic visit or a second opinion, first write down the questions you want answered. Then put changes in daily life, original test records, and medicines actually taken in chronological order. You can submit the records you already have and mark missing items as “not done” or “not yet obtained.” The receiving doctor will decide whether anything else is needed. When the patient can participate, involve them in decisions about sharing records and arranging the consultation.[1]

Key points

• Keep cognitive test scores together with the test date, language, educational background, and full report. Also record changes in daily abilities, such as taking medicines, going out, and eating.
• Provide original MRI images and reports, along with any existing biomarker or genetic reports in their original language. Do not arrange additional PET scans, lumbar punctures, or genetic tests yourself just to complete a checklist.
• If there is a sudden major change in awareness, a seizure, or suspected stroke symptoms, seek emergency care locally first. Do not wait for an appointment at another hospital or for records to be organized.[1]

Write a one-page history of the illness and changes in daily life

Write down the patient’s name, date of birth, usual language, educational background, and a contact person whose involvement the patient has agreed to. List approximately when changes were first noticed, previous diagnoses, and the two or three questions you most want this consultation to address. If a date is uncertain, write “approximately” rather than guessing an exact date.

Use examples to describe differences between the past and now: whether the patient takes medicines more than once by mistake, can handle payments, gets lost in familiar places, and how much help they need with eating, bathing, or during the night. Note whether changes developed gradually or suddenly over a few days, and whether they coincided with hospitalization, fever, a fall, a new medicine, or changes in sleep. Ask the patient and someone familiar with their daily life to add their observations separately. Avoid describing the situation only as “uncooperative.”

Organize tests, imaging, and existing results

Keep full cognitive test and neuropsychological assessment reports in date order. Include the test name, version, language, scores for individual sections, and total score, as well as any hearing or vision problems, fatigue, or other factors that may have affected testing. Scores from different tests or languages cannot simply be subtracted to judge change. Ask the doctor to interpret them alongside changes in daily abilities.[1]

Ask the imaging facility for the full brain MRI or CT report and any available original images. First check which formats the receiving team supports. For existing blood, cerebrospinal fluid, or PET reports, keep the test date, sample type, method, values, units, reference ranges, and conclusions. Do not send only a screenshot saying “positive.” For existing blood biomarker results, keep the test name, platform, sample type, and the laboratory’s interpretation. If the report says “intermediate range,” submit that wording as written; do not change it to positive or negative yourself.[3] If genetic testing has been done, bring the full report and the reason for testing, and have a doctor or genetics professional explain it. Some APOE variants are associated with risk, but this result alone cannot establish a diagnosis. Genetic testing to investigate an inherited cause in the family may answer different questions. If you do not have the report, mark it as not yet obtained.[4]

If the patient has an implanted device, cannot lie flat, or has previously been unable to complete an MRI, tell the hospital when booking so it can assess whether the scan is feasible. Keep wording such as “suspected” or “cannot be ruled out” exactly as it appears in existing reports, and submit any Chinese translation together with the original.

Record actual medicine use and antibody treatment separately

List the name, formulation, dose, actual frequency of use, and start or adjustment date for every prescription medicine, over-the-counter medicine, and supplement. Record missed doses, repeated doses, stopped medicines, and any discomfort or side effects accurately. For anticoagulant or antiplatelet medicines, give the specific name and reason for use. Ask the original doctor or a pharmacist to help verify any missing dosage information. Do not enter guessed values or stop medicines yourself.

If the patient has received anti-amyloid antibody treatment, make a separate record of the specific medicine, each administration date and dose, any pauses or restarts, existing MRI images and reports, infusion reactions or other important problems, and the original team’s next monitoring plan. If imaging abnormalities have occurred, include the original reports, images, and the doctor’s records of how they were managed. The receiving team will decide whether to continue treatment, obtain further tests, and schedule follow-up based on the specific medicine and applicable local rules.[2]

If new headaches, confusion, changes in vision or walking, seizures, or similar symptoms occur during treatment with lecanemab or donanemab, contact the treatment team immediately or go to the nearest emergency department. For sudden or severe symptoms, call local emergency services directly. People receiving other anti-amyloid antibodies should also ask their treatment team in advance for a written personal monitoring plan and instructions on seeking help for problems. When seeking care, state the specific medicine and the date of the most recent dose. Do not decide the cause yourself.[2][5]

Confirm receipt and follow-up arrangements before submitting records

First ask the hospital which language, file formats, original images, and secure submission channels it requires. After the patient or a legally authorized person has consented, send a one-page contents list and the available records. Ask the receiving team to confirm that files can be opened, what is still missing, when an opinion is expected, and whether this appointment is a records review or an in-person clinic visit. Receipt of files alone does not mean that a diagnosis or treatment has been confirmed.

Before the consultation, discuss care during the waiting period with the current doctor. After the consultation, obtain the written conclusions, any results that remain unexplained, the next follow-up assessment, the medicine list, and a contact person. Ask the local doctor taking over care to confirm receipt. Agree with the patient and caregiver on who will arrange tests and prescriptions, and how to seek help if problems arise.

Frequently asked questions

Can we book an appointment without all the reports?

Ask the hospital first. List the records you have, tests that have not been done, and records you are requesting. The receiving team will decide which are necessary for the questions being addressed.

If a cognitive score drops by a few points between two tests, does that mean the condition has worsened?

The difference alone cannot establish this. Bring the full reports, the testing language, and information about the patient’s condition at the time. Ask the doctor to interpret these alongside actual changes in daily life.[1]

If a blood biomarker result says positive, can we send just that page?

It is best to provide the full report, including the method, units, and reference ranges, along with symptoms and other existing test results. A doctor should interpret the result in its clinical context.

Do we still need to keep MRI records if there are no symptoms after antibody treatment?

Yes. Ask the original team to provide existing images, reports, and the monitoring plan. The receiving team needs to assess whether these are sufficient for comparison. Do not skip tests arranged by the doctor on your own.[2]

Can family members provide information if the patient has difficulty expressing themselves?

They can add observations about daily life, but involve the patient as much as possible and confirm consent to sharing and any necessary authorization according to the hospital’s requirements. Family observations and the patient’s own views can be recorded separately.[1]

Is the consultation complete once photos of the reports have been sent?

No. Ask the receiving team to confirm that the records are readable, the appointment format, and when feedback is expected. The responsible doctor still needs to provide the consultation conclusions and prescriptions.

If the condition suddenly worsens, should we finish organizing records before contacting a doctor?

No. For a sudden severe change in awareness, weakness on one side, speech problems, or seizures, go to the nearest emergency department or call local emergency services first. Provide the remaining records afterward.[1]

Sources

1. UK NICE: Dementia assessment, management, and support, checked 2026-11-06. This UK guideline helps explain assessment; it does not represent the service policies of institutions in China.
2. US FDA: Leqembi 2026 prescribing information, checked 2026-11-06. Used to explain monitoring and symptoms for this medicine; US dosing schedules should not be applied to other countries or medicines.
3. Alzheimer’s Association: Clinical practice guideline on blood-based biomarkers in specialty care, checked 2026-11-06. Specialists must interpret tests in light of the method and clinical circumstances.
4. Alzheimer’s Association: Diagnostic tests and genetic risk, checked 2026-11-06. The purpose and results of genetic testing must be explained by a qualified professional.
5. US FDA: Kisunla (donanemab) 2025 prescribing information, checked 2026-11-06. Used to explain warnings for this product; US monitoring schedules should not be applied to other medicines or regions.