Alzheimer’s disease is not a normal part of aging.
Memory problems are typically one of the first warning signs of cognitive loss.
According to the National Institute on Aging, in addition to memory problems, someone with Alzheimer’s disease may experience one or more of the following signs:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills. Difficulty completing familiar tasks at home, at work or at leisure.
- Decreased or poor judgment. Misplaces things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavioral.
If you or someone you know has several or even most of the signs listed above, it does not mean that you or they have Alzheimer’s disease. It is important to consult a health care provider when you or someone you know has concerns about memory loss, thinking skills, or behavioral changes. Some causes for symptoms, such as depression and drug interactions, are reversible. However, they can be serious and should be identified and treated by a health care provider as soon as possible.
Early and accurate diagnosis provides opportunities for you and your family to consider or review financial planning, develop advance directives, enroll in clinical trials, and anticipate care needs. Doctors use several methods and tools to help determine whether a person who is having memory problems has “possible Alzheimer’s dementia” (dementia may be due to another cause), “probable Alzheimer’s dementia” (no other cause for dementia can be found), or some other problem. Doctors assess whether a person has an underlying treatable condition such as depression, abnormal thyroid function, normal pressure hydrocephalus, or vitamin B12 deficiency. A medical assessment for dementia generally includes:
- Patient history: Typical questions about a person’s medical and family history might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
- Physical exam: Measuring blood pressure and other vital signs may help physicians detect conditions that might cause or occur with dementia. Such conditions may be treatable.
- Neurological tests: Assessing balance, sensory function, reflexes, vision, eye movements, and other cognitive functions helps identify conditions that may affect the diagnosis or are treatable with drugs.
To diagnose Alzheimer’s, doctors may use the following procedures:
- Cognitive and neuropsychological tests. These tests measure memory, problem solving, attention, counting, language skills, and other abilities related to mental functioning.
- Laboratory tests. Blood and urine tests can help find or rule out possible causes of symptoms.
- Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain’s structure and function. The most common scans are: Computed tomography (CT), which uses X-rays to produce images of the brain and other organs Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves Positron emission tomography (PET), which uses radiation to provide pictures of brain activity
- Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
- Genetic tests. Some dementias are caused by a known gene defect. In these cases, a genetic test can help people know if they are at risk for dementia. People should talk with family members, a primary care doctor, and genetic counselor.
These tests may be repeated to give doctors information about how the person’s memory and other cognitive functions are changing over time. They can also help diagnose other causes of memory problems, such as stroke, tumor, Parkinson’s disease, sleep disturbances, side effects of medication, an infection, mild cognitive impairment, or a non-Alzheimer’s dementia, including vascular dementia. Some of these conditions may be treatable and possibly reversible. People with memory problems should return to the doctor every 6 to 12 months. It’s important to note that Alzheimer’s disease can be definitively diagnosed only after death, by linking clinical measures with an examination of brain tissue in an autopsy.
What Happens Next?
If a primary care doctor suspects mild cognitive impairment or possible Alzheimer’s, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans
- Neuropsychologists, who can conduct tests of memory and thinking
Memory clinics and centers, including Alzheimer’s Disease Research Centers, offer teams of specialists who work together to diagnose the problem. Tests often are done at the clinic or center, which can speed up diagnosis.
What Are the Benefits of Early Diagnosis?
Early, accurate diagnosis is beneficial for several reasons. Beginning treatment early in the disease process may help preserve daily functioning for some time, even though the underlying Alzheimer’s process cannot be stopped or reversed.Early diagnosis is important, as some causes for symptoms can be treated. Having an early diagnosis helps people with Alzheimer’s and their families:
- Plan for the future
- Take care of financial and legal matters
- Address potential safety issues
- Learn about living arrangements
- Develop support networks
In addition, an early diagnosis gives people greater opportunities to participate in clinical trials that are testing possible new treatments for Alzheimer’s disease or in other research studies.
Sources:
https://nia.nih.gov/health/how-alzheimers-disease-diagnosed
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