Diagnosis of Alzheimer Disease
Finding Out If It
Is Alzheimer Disease
Alzheimer Disease is a progressive, degenerative disease. Symptoms
include loss of memory, judgment and reasoning; difficulty with
day-to-day tasks; and changes in communication abilities, mood and
behaviour. If you notice any of these symptoms, it is important to
see your doctor.
Why Find Out?
Symptoms of Alzheimer Disease can be similar to symptoms of other
conditions such as depression, thyroid or heart disease, infections,
drug interactions or alcohol abuse. Finding out the cause of
the symptoms can help people:
Making the
Diagnosis
There
is currently no single test that can tell if a person has Alzheimer
Disease. The diagnosis is made through a systematic assessment which
eliminates other possible causes. Until the time when there is a
conclusive test, doctors may continue to use the words "probable
Alzheimer Disease." However, you should be aware that doctors making
this diagnosis are accurate 80 to 90 per cent of the time.
Making the diagnosis can take time. The diagnosis can be made in a
family doctor's office, a memory clinic or a hospital. The doctor
may or may not feel that the person needs to see a number of
health-care professionals to help make the diagnosis. These may
include a psychologist, psychiatrist, neurologist, geriatrician,
nurse, social worker or occupational therapist. They will look for
problems with the person's memory, reasoning ability, language and
judgment, and how these affect day-to-day functions.
Medical history
Both the individual and family members or friends will be asked
questions regarding the person's symptoms now and in the past. There
will be questions about past illnesses and about family medical and
psychiatric history.
Mental status exam
This part of the process tests the person's sense of time and place
as well as the ability to remember, express herself and do simple
calculations. It may involve exercises such as recalling words and
objects, drawing and spelling, and questions such as "What year is
it?"
Physical exam
To help rule out other causes, a physical exam will be done. The
doctor will look for heart, lung, liver, kidney or thyroid problems
that may be causing the symptoms. To evaluate whether other nervous
system disorders are causing the symptoms, the doctor will test
muscle tone and strength, co-ordination, eye movement, speech and
sensation.
Laboratory tests
A number of tests will be done. Detailed blood work will be ordered
to help detect problems such as anemia, diabetes, thyroid problems
or infections that might be contributing to the symptoms.
Other
tests such as X-rays and EEG's (electroencephalogram) may be used to
determine the source of the problem. In some centres, scans may be
used. The following may be recommended, but are not always necessary
for a diagnosis:
CT
(computerized tomography) scan and MRI (magnetic resonance
imaging) take images of the brain.
SPECT (single proton emission computed tomography) shows how
blood is circulating to the brain.
PET (positive electron tomography) shows how the different areas
of the brain respond during certain activities such as reading and
talking.
Psychiatric and psychological evaluations
A psychiatric evaluation may be helpful in ruling out other
illnesses such as depression which can cause symptoms similar to
Alzheimer Disease. Neuro-psychological testing can evaluate memory,
reasoning, writing, etc.
Tips to
lend a hand:
-
Make the
appointment for the person
-
Help
with transportation
-
Offer to
accompany the person to appointments and tests
-
Help
prepare information for the first appointment
-
Appreciate that this can be an unsettling time for the person and
provide emotional support
-
Have
patience; it can take a long period of time to arrive at a diagnosis
Finding
Support
Please call your local Alzheimer Society at any time in the process
for additional information, community referral or support.
If the
Diagnosis is Alzheimer Disease
You
may want to ask:
-
What does the diagnosis mean?
-
What can be expected over time?
-
What care will be needed and is available, now and in the
future?
-
What treatment is available? What are the risks and benefits?
-
What resources are available in the community to help?
-
Are there any experimental drug trials to participate in?
-
When is the next appointment?
Get the facts!
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