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Basic InformationMore InformationLatest NewsVets With Stress Disorder More Likely to Develop DementiaMental 'Exercise' May Only Hide Signs of Alzheimer'sBiobehavioral Approach Linked to Benefits in DementiaHealth Tip: Signs That People With Dementia Shouldn't DriveLink Between Diabetes, Alzheimer's Disease StrengthenedDeep Brain Stimulation Studied for Alzheimer'sThree Genotypes Confirmed as Alzheimer's Disease Risk Loci'Biomarkers' Could Spot Alzheimer's Disease Early, Studies SuggestDeep Brain Stimulation May Hold Promise in Alzheimer'sCould Lifestyle Changes Cut Dementia Rates?Higher Education Level May Help Brain Cope With DementiaDementia May Differ in Those With and Without DiabetesNew Criteria for Alzheimer's Diagnosis ProposedAssociation Found Between Alzheimer's and AnemiaAlzheimer's Research Spotlights Protein 'Tangles' in BrainEmotions May Be Blunted in Alzheimer's PatientsExercise, Vitamin D Seem to Cut Alzheimer's Risk: ResearchersBlood Protein Reflects Severity and Progression in Alzheimer'sDepression Linked to Higher Risk of Alzheimer's, DementiaNew Alzheimer's Clues IdentifiedPredicting Alzheimer's Risk in Patients With Cognitive ProblemsExercise May Guard Girls Against Dementia in Senior YearsExperts Optimistic About Solving Puzzle of Alzheimer'sBrain Stimulation Seems to Boost Language Skills in Alzheimer's PatientsScant Evidence Links Any Factor to Alzheimer's PreventionLifestyle Changes Are No Guarantee Against Alzheimer'sNew Potential Cause of Alzheimer's Disease DetectedSpecific Care Plan Does Not Slow Decline in Alzheimer'sBrain Injury Patients Plagued by Poor Sleep, DepressionA Protein Links Alzheimer's, Down SyndromeAlzheimer's Costs Could Explode by Mid-CenturyMajor Depression Often Follows Brain InjuryTreating Common Irregular Heartbeat Might Also Ward Off Alzheimer'sNew Alzheimer's Risk Genes IdentifiedIf Your Spouse Gets Alzheimer's, You Might, TooSurgery for Treatable Dementia Might Also Help in Alzheimer'sNew Finding Could Mark Shift in Alzheimer's ResearchAbnormal Heart Rhythm Linked to Alzheimer'sTreatment Eases Involuntary Laughing, Crying Tied to Alzheimer's, MSNew Alzheimer's Gene IdentifiedEven As Memory Fades, Emotions LingerIn Alzheimer's, Reduced Lean Mass Tied to Brain AtrophyHealthy Diet Could Cut Alzheimer's Disease RiskDocs Issue Guidelines for Drivers With DementiaSimple Memory Test May Detect Early Alzheimer'sAmericans Sustain 1.7 Million Traumatic Brain Injuries a YearBrain Function May Drop Quickly Before Alzheimer'sClinical Trials Update: March 22, 2010Could Lowering Blood Pressure Help Stop Dementia?Technique Shows Potential of Bapineuzumab in Alzheimer's Questions and AnswersLinksBook Reviews |
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Diagnosis of Alzheimer's DiseaseCarrie Hill, Ph.D. and Natalie Reiss, Ph.D.Previously, the plaques and tangles that accumulate in the brain (described previously, click here to return to that discussion) with Alzheimer's disease could only be definitively identified through autopsy. In other words, there was no available test or procedure to "pull out" a small sample of the brain to determine whether someone had developed plaques or tangles while they were still alive.
Currently, scientists are working on imaging procedures (described below, procedures that provide information about the structure and function of the brain) that will allow us to use brain scans and computers to aid in diagnosis. However, because using imaging technology to diagnose AD is still relatively new, the old standard of using a battery of tests for diagnosis is still the accepted procedure. The good news is that when a qualified physician does a thorough examination - which usually takes more than one visit - Alzheimer's disease can be diagnosed while the person is still alive, and we can be over 90% sure that the diagnosis is correct.
An even better method than relying on a single physician for diagnosis - although not always available outside of metropolitan areas with large research and teaching hospitals - is to approach diagnosis and treatment with an interdisciplinary team that includes a geriatrician (i.e., a physician who specializes in working with older people), a neurologist (i.e., a physician who specializes in diseases of the nervous system), a psychologist (i.e., a doctor who specializes in mood and behavioral disorders), a neuropsychologist (i.e., a doctor who can perform testing to identify the nature and level of cognitive symptoms), and a social worker (i.e., a social services professional who can link individuals and families to community services).
The goal of a diagnostic workup is to rule out any other possible condition (reversible or irreversible) that could be creating the Alzheimer's-like symptoms. Appropriate diagnosis is crucial to making treatment recommendations (particularly if the condition can be reversed) that are likely to be beneficial. There are several components in a diagnostic workup, including:
- Medical history - This includes questions about prior illnesses, previous injuries and surgeries, and current chronic conditions in order to identify other possible causes for Alzheimer's-like symptoms. For instance, a serious head injury - even from long ago - could account for problems with memory or concentration, or heart disease could be reducing blood flow to the brain and causing forgetfulness.
- Medication history - This includes questions about allergies, side effects from past medications, and a list of current medications and dosages. Not only will this information help guide any future prescription decisions, it also might reveal a medication interaction (when two or more medications work against or compound the effects of each other) or overdosage that accounts for confusion and other symptoms.
- Complete physical exam - This includes an assessment of hearing, vision, blood pressure, pulse, and other basic indicators of health and disease. A current physical exam can detect acute medical conditions such as an infection that might be causing confusion and other Alzheimer's-like symptoms.
- Laboratory tests - This may include a battery of tests, depending on the individual's medical history and current symptoms. For example, a blood glucose test might be ordered if the person is exhibiting symptoms of diabetes such as frequent urination, blurred vision, or increased thirst. Symptoms that came on suddenly and include severe confusion would warrant a urinalysis to rule out a urinary tract infection. Some scientists are currently refining a procedure that would allow a doctor to analyze a sample of cerebrospinal fluid (the fluid that surrounds and protects the brain and spinal cord) for the characteristic abnormal proteins that build up with Alzheimer's Disease.
- Neurological exam - This is a specific type of exam that is used to identify problems with the brain and nervous system. The evaluation should include an examination of the motor system (i.e., movement), reflexes, gait (i.e., walking), sensory functioning, and coordination in order to detect nervous system problems that may be causing difficulties with thinking and behavior.
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