Swank Center for Memory Care

The Swank Center works with patients 50 and older who are concerned because of suspected cognitive symptoms or who have a significant family history of dementia. Swank sees patients who reside in the community (living independently, in assisted living or with family members).

Our program is specially designed to support individuals living in the community—whether at home, in independent living, or assisted living—along with their caregivers. For those residing in skilled nursing or memory care facilities, care is often best coordinated directly through the providers within those settings, who are familiar with the day-to-day needs and routines of their residents. We’re happy to help guide families to appropriate resources or answer questions about care options.

Disease-modifying therapies are treatments that may slow the progression of Alzheimer’s disease. Currently, two approved medications— Leqembi (lecanemab) and Kisunla (donanemab)—are available and are given through a series of infusions over 12 to 18 months. However, these treatments are not suitable for everyone. Before starting either medication, patients need to undergo a thorough evaluation, including genetic testing, memory and thinking assessments that typically include brain imaging and lab tests to ensure the treatment is safe and appropriate. It is important to note that these therapies do not reverse existing cognitive impairment, nor do they stop the progression of further cognitive decline.

Mild cognitive impairment (MCI) is a condition in which one has memory and/or other cognitive complaints that are noticeable to the patient or others and create difficulty, but do not cause severe impairment in functioning. In other words, patients with MCI while needing reminders and other assistance, can still generally function independently. Patients with dementia, on the other hand, have cognitive complaints that do result in severe impairment in functioning. These patients struggle with activities of daily living (ADL’s) and their level of impairment is such that they have difficulty functioning independently.

Dementia, or what is also called major neurocognitive disorder, is a condition in which there are changes to the brain that cause significant impairment in functioning. Cognitive symptoms of dementia can include memory loss, difficulty with language, emotional disturbances, impaired judgment, psychiatric symptoms (depression, anxiety, psychosis), and changes in personality or behavior. Many conditions can cause dementia.

Alzheimer’s disease is the most common cause of dementia, but other conditions also cause dementia such as Parkinson’s disease, Lewy Body disease, Frontotemporal dementia, vascular dementia, certain infections, and vitamin deficiencies amongst others. A thorough memory disorders assessment includes studies to rule out these conditions.

Questions of legal capacity related to health care decision-making, finances, exploitation or abuse, and living arrangements commonly arise in patients with memory disorders. These matters may require the involvement of the legal system and a judicial determination of competency. In order to maintain the integrity of the doctor/patient relationship, Swank providers do not perform capacity assessments, nor do we complete competency evaluation paperwork for legal purposes. The Swank Center provides outstanding clinical care to our patients. Our program is not designed to provide the forensic consultative services that are required under such circumstances.

Diagnosing dementia involves gathering information from your medical history, brain scans (like MRI or CT), and lab tests. Today, several newer tests that help doctors more accurately identify memory and thinking problems, such as mild cognitive impairment (MCI) or dementia. These include:

• Amyloid PET Scan: A brain amyloid PET scan for Alzheimer's disease is a specialized imaging test that uses a radioactive tracer to detect amyloid plaques in the brain—one of the hallmark features of Alzheimer’s.
• Testing for blood biomarkers: Biomarkers are tiny substances in your blood that can give us clues about your health. In Alzheimer’s, two key proteins—amyloid and tau— build up in the brain and harm brain cells. These proteins can leak into the blood, and we can now test for them using a simple blood sample.

Biomarkers help us detect Alzheimer’s earlier and start treatment sooner, which may slow down the disease.

• Alpha-synuclein Biopsy: A skin biopsy test can help diagnose Parkinson’s disease and Lewy body dementia by detecting a protein called alpha-synuclein, which builds up abnormally in the nerve fibers of people with these conditions.
• FDG PET Imaging Study: A FDG PET scan is a brain imaging test that helps doctors diagnose and distinguish between types of dementia by showing how different areas of the brain use glucose, the brain’s main energy source. Low glucose uptake in specific brain regions can signal early signs of Alzheimer’s, frontotemporal dementia, or other conditions.

Having a family history of dementia can increase your risk, but many factors —like lifestyle, environment, and genetics—play a role, too. At the Swank Center, our specialists work closely with ChristianaCare’s Department of Genetics to help you better understand how inherited traits and specific genetic markers may affect your personal risk. We’re here to support you with information, testing options, and guidance tailored to your needs.