Brain imaging like MRI is recommended to rule out tumors and assess vascular burden or atrophy, especially in the frontal, temporal lobes, and hippocampus.

“we always have to do some brain imaging either a cat scan got a rule out a tumor or a MRI now the American Academy Neurology states you can do any brain imaging I'm in my clinical practice we always recommend an MRI and what phase of MRI just a regular MRI no contrast I just want to make who is that which image you looking at the t1 or t2 well I want to look at everything you know is their vascular burden could this be vascular cognitive impairment by itself could this be vascular and Alzheimer's was about 35% of the time you have Alzheimer's and vascular cognitive impairment so you just want to get a sense of what it looks like”