Diagnosing Alzheimer’s Disease

LS Fisher, Alzheimer’s Journey, September 22, 2011

An Alzheimer’s diagnosis is the first step of a journey that can last up to 20 years. Diagnosis is a collaborative effort between you, your family physician and specialists who will administer and interpret test results. No single test determines if you have Alzheimer’s disease.

If you are forgetful, confused, or make poor decisions that interfere with your daily life, it is time to have a complete examination to investigate the cause. Although you have symptoms of Alzheimer’s, you should not assume you have the disease. Dementia symptoms can be caused by treatable conditions.

You will want to make an appointment with your primary care physician as soon as possible. With a proper medical workup, your physicians can diagnose Alzheimer’s disease with nearly 90% accuracy.

Advantages of Early Diagnosis:

  • Treatments: Available treatments are more effective during the early stages.
  • Financial and medical planning: As an active participant, you will be assured your financial affairs reflect your personal preferences. You can prepare an advance directive and decide who will make the best medical decisions for you when you cannot make them yourself.
  • Family dynamics: You will have time to discuss how this disease will affect not only you, but also your family. You will need their support, and they need to know you care about their wellbeing as they adjust to new responsibilities.

What to Expect

Think of diagnosis as an investigative process to determine the cause of your symptoms. Other conditions produce symptoms similar to Alzheimer’s, and your physician may request tests to eliminate other forms of dementia and identify co-existing conditions. You will undergo a complete physical examination, diagnostic tests, and cognitive function tests. Be proactive during this phase to help your medical team make the most accurate diagnosis of your condition.

Before your appointment, review your medical history. If you do not have access to a computer, have a friend or family member make an electronic document of your medical history. Document all surgeries, tests (and results), and medical conditions you have. List medications you take, or have taken recently including dosage. Your list should also include over-the-counter supplements. Keep this list updated and take it with you to appointments. This list will help you fill out medical forms with accuracy and ensures that every medical professional you visit has a comprehensive medical history.

Your primary physician may refer you to a psychiatrist, neurologist, neuropsychologist, or other specialist. The psychiatrist will evaluate you for depression or other possible causes for your symptoms. He may perform tests or refer you to a neuropsychologist to test your memory, abstract thinking, language, and other cognitive functions. A neurologist will conduct the tests for changes to the brain that might indicate Alzheimer’s or other degenerative brain disorders.

It is important to keep all appointments and arrive on time. If you have to travel to an unfamiliar office, allow ample travel time and have good directions. Ask a trusted friend or family member to accompany you and request permission for your companion to be present during medical consultations.

Diagnostic Tests

Your individual medical history will determine the tests your doctor orders. If you don’t understand why you are being asked to undergo a test, ask your physician to explain.

Tests may include:

  • Cognitive testing: Neuropsychological testing will help your physician determine if you have dementia of the Alzheimer’s type. The mini-mental status examination (MMSE), or a similar test, allows your physician to determine whether further testing is warranted.
  • Comprehensive blood tests:  Lab tests are necessary to rule out other causes of dementia. Genetic testing may be recommended, especially if family members have dementia or hereditary forms of Alzheimer’s.
  • Brain scans: Brain imaging allows your medical team to see brain abnormalities. You may be asked to have some of these scans: computerized tomography (CT) to show cross-sectional brain images; magnetic resonance imaging (MRI) to view the structure of the brain to rule out brain tumors, strokes, or other conditions; positron emission tomography (PET) scan to show brain activity; electroencephalogram (EEG) to measure electric activity in the brain.

Life does not end with an Alzheimer’s diagnosis, and you should take action to ensure the highest possible quality of life. Concentrate on what you can do rather than what you can’t. Seeking an early and accurate diagnosis is essential for you to make informed decisions. Investigate your options and let your family help you with difficult choices.

 

Sources:

Alzheimer’s Association. Medical Evaluation. Accessed: July 9, 2011. http://www.alz.org/alzheimers_disease_steps_to_diagnosis.asp#brain

Fisher Center for Alzheimer’s Research Foundation. Alzheimer’s Diagnostic Tests. Accessed: July 9, 2011.

http://www.alzinfo.org/07/about-alzheimers/alzheimers-diagnostic-tests

 

 

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