If this is an emergency, call 911. Sudden confusion, trouble speaking or understanding, weakness or numbness on one side, facial droop, or sudden vision loss can be signs of a stroke and need emergency care right away. This article is general education, not medical advice, and it does not create a doctor-patient relationship.
The short answer
Memory changes are common and have many causes. Some of them are treatable. Mild cognitive impairment (MCI) means measurable changes in thinking that are greater than expected for age but do not stop a person from managing daily life. MCI becomes more common with age. A guideline review estimated prevalence at about 7% of people aged 60-64 and about 25% of those aged 80-84 (Petersen et al., 2018). Not everyone with MCI goes on to develop dementia. Because the stakes feel high and the diagnosis can be uncertain, a second opinion is reasonable when the evaluation seems incomplete, when the label doesn't fit what you are seeing, or before a major treatment decision.
Estimated share of people with mild cognitive impairment, by age
Why memory diagnoses can be uncertain
Diagnosing the cause of memory changes is genuinely difficult, even for experts. In one study comparing clinical diagnoses at specialist research centers with later brain autopsy findings, the clinical diagnosis of Alzheimer disease had a sensitivity of roughly 71-87% and a specificity of roughly 44-71% (Beach et al., 2012). Still, the point stands: two careful clinicians can reasonably reach different conclusions.
Many factors can affect memory and thinking. They are worth reviewing before settling on a diagnosis. These include:
Medication side effects, especially sleep aids, some bladder and allergy medicines, and combinations of drugs.
Thyroid or vitamin B12 problems.
Hearing loss, which is also identified as a modifiable risk factor for dementia (Livingston et al., 2024).
The US Preventive Services Task Force notes that finding cognitive impairment early can allow reversible causes to be identified and treated. The American Academy of Neurology advises stopping medications that impair thinking where possible.
When to seek a second opinion
You or a family member received a diagnosis (MCI, dementia, Alzheimer disease) after a brief visit without detailed testing.
Your concerns were dismissed as "just aging," but the changes are affecting daily life.
Results conflict, for example normal brief screening tests but clear changes noticed at home or work.
Changes began after a head injury, stroke or illness, and it is unclear how they are connected.
You are deciding whether to pursue newer treatments or specialized tests and want an independent review of the evidence.
What a second opinion can and can't do
It can:
- Review the evaluation done so far and identify gaps, such as possible contributing factors that have not been checked.
- Explain what tests like cognitive screening, neuropsychological testing, MRI or biomarkers can and cannot show.
- Help you prepare focused questions for your treating neurologist or primary care physician.
- Summarize what published evidence says about options you are considering.
It can't:
- Perform full in-person neuropsychological testing over video.
- Prescribe or manage ongoing treatment. Your own clinicians continue your care.
- Guarantee a different or more favorable diagnosis.
- Predict with certainty whether MCI will progress.
How a second opinion works
- Register interestJoin the waitlist. Bookings are not yet open.
- Send records securelyReports, imaging and notes by secure email or fax. Nothing through the website.
- Physician reviewDr. Hadanny reviews your records and the relevant evidence before the visit.
- Video visitA secure video consultation while you are in Florida, New York or Arizona.
- Written opinionA written summary for you to share with your own doctors, who continue your care.
What to prepare
- A timeline: when changes were first noticed, by whom, and how they have changed. Specific examples help.
- If possible, input from a family member or close friend who knows you well. With your permission, they can join the visit.
- Notes from primary care, neurology, psychiatry or geriatrics.
- Cognitive test results (for example MoCA or MMSE scores) and any neuropsychological testing reports.
- Brain imaging reports, and images if available.
- Recent lab results.
- A complete list of medications and supplements, including over-the-counter sleep and allergy medicines.
- Your three to five most important questions.
How records are sent: Records are sent through a secure, encrypted channel or secure fax, using instructions we provide after enrollment. Please never send medical records or health details by regular email, web forms or social media.
Frequently asked questions
Is forgetfulness a normal part of aging? Some slowing, such as occasionally misplacing things or taking longer to recall names, is common with age. Changes that affect your ability to manage daily tasks, or that clearly progress over months, deserve evaluation.
Does MCI always become dementia? No. Some people stay stable, and some return to normal thinking on follow-up, although some of those who improve later decline again.
Should a family member join? Often yes, with the patient's consent. Someone who knows you well often adds information that testing alone can miss.
Who can use this service? Adults located in Florida, New York or Arizona at the time of the video visit.
References
- Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126-135. doi:10.1212/WNL.0000000000004826. https://pubmed.ncbi.nlm.nih.gov/29282327/ (PubMed lists this guideline as retired. Check for the current AAN position.)
- Beach TG, Monsell SE, Phillips LE, Kukull W. Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005-2010. J Neuropathol Exp Neurol. 2012;71(4):266-273. doi:10.1097/NEN.0b013e31824b211b. https://pubmed.ncbi.nlm.nih.gov/22437338/
- Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024;404(10452):572-628. https://pubmed.ncbi.nlm.nih.gov/39096926/
- US Preventive Services Task Force; Owens DK, Davidson KW, Krist AH, et al. Screening for cognitive impairment in older adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(8):757-763. https://pubmed.ncbi.nlm.nih.gov/32096858/
- Knopman DS, DeKosky ST, Cummings JL, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56(9):1143-1153. https://pubmed.ncbi.nlm.nih.gov/11342678/ (older guideline; recommends screening for depression, B12 deficiency and hypothyroidism)
Reviewer note: all references were verified against PubMed records (authors, title, journal, year, volume, pages) on 2026-11-11. Author lists follow AMA style. The NIA pages "Assessing Cognitive Impairment in Older Patients" and "What Is Mild Cognitive Impairment?" were removed because their URLs could not be confirmed.
Video second opinions are not yet open for booking. If you would like to hear when they open, you can join the waitlist. We only ask for your name, email and state. Please don't include any health information.
This article is for general education and is not medical advice. Reading it does not create a doctor-patient relationship. If this is an emergency, call 911.