Alzheimer's
Disease, generally limited to the elder population, is the leading cause of dementia,
and characterized by symptoms that
includes loss of memory, judgment and reasoning, difficulty with
normal daily functions, changes in personality or mood, and atypical
behavior.
In
these cases, Alzheimer's Disease is not always the cause.
There are many causes for the above symptoms, many that are
treatable. But if you have
noticed these symptoms in yourself, or in someone close to you, it
is important to visit your family doctor for a thorough assessment
to find the cause.
Some
of the conditions that cause dementia, that may be treatable,
include:
- depression
- thyroid
or heart disease
- infections
- drug
interactions
- alcohol
abuse
- not
enough to eat or drink
Why
Diagnosis?
Finding
out the causes of the symptoms can help individuals:
- understand
the source of symptoms
- get
the proper care, treatment and support
- plan
for the future
The
Diagnosis
There
is currently no single test that can tell if a person has Alzheimer's
Disease. The diagnosis is made through a systematic assessment which
eliminates other possible causes. Until the time when there is a
conclusive test, doctors will continue to use the words
"probable Alzheimer's Disease." Don't let these words fool
you; 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, a hospital or in the community.
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 function.
The
process involves:
Examining
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.
Determining
Mental Condition
This
part of the process tests the person's sense of time and place as
well as the ability to remember, express him/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?"
Thorough
Physical
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.
Testing
A
number of tests will be done. Detailed blood work will be ordered to
help detect problems such as anemia, diabetes, thyroid problems or
infection that might be causing the symptoms.
Other
tests such as X-rays and EEG's (electroencephalogram) may be used to
determine the source of the problem. In some centers, scans may be
used. These 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 memory loss similar to Alzheimer
Disease. Neuro-psychological testing can evaluate memory, reasoning,
writing, etc.
Preparing
for the Assessment
On
the day of the appointment, it will be useful to have the following
information on hand. Writing this information down ahead of time can
be helpful.
Things you
will be asked
- What
symptoms have been noticed?
- When
did they first appear?
- How
have the symptoms changed over time?
- What
other medical conditions does the person have?
- What
medications are currently being taken (both prescription and
over-the-counter)?
- Is
there a family history of Alzheimer Disease,
"senility," "hardening of the arteries," neurological
or psychiatric conditions?
Things you
may want to ask
- Which
tests will be performed? What is involved in the tests?
- How
long will the tests take?
- How
long will it take to learn the results?
- How
do we learn the results? Who will be involved?
Tips to
Make Things Easier
- Make
the appointment for the person.
- Help
with transportation.
- Share
this information with other family members.
- 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.
What
if the Diagnosis is Alzheimer's 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?
