Alzheimer's Versus Normal Forgetfulness
Don't panic at the first sign of forgetfulness. It's normal to forget from time to time where you put your glasses or the overdue library book. Alzheimer's is not a minor episode of forgetfulness, nor is it a sudden change in cognition; rather, it's a gradual progression of symptoms over time. So, keep track of the symptoms over the course of a few months. Consider asking a trusted family or friend for input as well. (Any significant, sudden change in someone's ability to think clearly merits a call to your doctor immediately.)
What Kind of Doctor Should You Call?
Several different kinds of physicians can diagnose Alzheimer's disease. You can make an appointment with your primary care doctor or seek out a specialist such as a psychologist, neurologist or geropsychiatrist. Some communities have specific programs that specialize in Alzheimer's testing and diagnosing, so check out your local Alzheimer's Association for recommendations as well. When calling to make the appointment, briefly share your observations and ask for an evaluation for Alzheimer's.
Why Get Diagnosed?
If you're like some people I've spoken with, you may feel like you'd rather not know if you or your loved one has Alzheimer's. After all, what's the point? Why go to the doctor to hear something that may be very hard to hear? While receiving this kind of news is difficult, there are some benefits to receiving a diagnosis.
- Early Treatment
An accurate diagnosis early in Alzheimer's allows for appropriate treatment to begin sooner. There are some medications that appear to work more effectively if given early in the stages of Alzheimer's.
- Control Over Decisions
Early diagnosis also allows time for you to plan ahead and make decisions. Although difficult, knowing what you or your loved one is facing can allow you some control over how the progression and effects of Alzheimer's disease are handled.
- Improved Coping
Having a name for the various symptoms you or your loved one has experienced can sometimes provide a sense of relief, despite the sadness that may accompany it. As you increase your understanding of Alzheimer's, you may also be able to more effectively cope with your feelings about the disease and its challenges.
How Is Alzheimer's Disease Diagnosed?A definitive diagnosis of Alzheimer's disease cannot be made until after death when a brain autopsy is conducted. A physician can, however, diagnose Alzheimer's with reasonable certainty by conducting several tests that can eliminate other causes of confusion and memory loss and by comparing symptoms with those of Alzheimer's. The following are often considered when diagnosing Alzheimer's disease:
- Reports of Symptoms
The physician may ask the person and a loved one to tell them about the symptoms they've experienced to determine if they are consistent with the symptoms of Alzheimer's disease.
- Mental Status Exams
A mental status exam is often used to objectively evaluate cognitive functioning. There are several ways to evaluate cognition, but one of the more common exams is the Mini Mental State Exam. This exam tests different aspects of the ability of the brain, such as memory, calculation, orientation and communication.
- Imaging Tests
Brain changes can also be observed through various imaging techniques such as a positron emission tomography (PET) scan, a computed tomography (CT) scan and an magnetic resonance imaging (MRI) test. These tests can assess the brain for any changes in size and structure, as well as rule out a tumor or other abnormality.
- Laboratory Tests
Some physicians will order tests such as blood work or a urinalysis. These tests can screen for infections or other medical conditions that could hinder your ability to think clearly. Infections can often cause increased confusion, especially in older adults, so it's important to eliminate these and other reversible conditions as a cause.
- Evaluation for Conditions that Mimic Alzheimer's
The exam should include an evaluation for reversible conditions that can mimic Alzheimer's disease, such as depression and delirium, and tests to differentiate between Alzheimer's and other types of dementia such as vascular dementia, Pick's disease, Parkinson's disease dementia and Creutzfeldt-Jakob disease.
Discussion of Your Overall Health Condition
You may be asked if there are other health conditions that you have been diagnosed with or any additional symptoms you've been experiencing. If you're at a new doctor's office, they may request that you have your records sent from your primary care physician ahead of time so that they know your history and current medical condition.
How Should You Prepare for the Doctor Appointment?Make a list of your symptoms and any questions you can think of before you go. This will help ensure you get the information you need and want from the appointment. It's often very helpful to have a second set of ears along at this doctor's appointment. This person can help you by providing additional information to the doctor, asking other questions about the tests and process of evaluation and, most importantly, being there to support you.
Receiving ResultsSome physicians will discuss their diagnosis with you at this appointment and others will schedule a follow-up appointment to share their findings. It can be nerve-racking to wait for answers and scary to receive a diagnosis, but knowing what you're facing can allow you to cope and prepare for the future, as well as receive early treatment. If, after the exam, the diagnosis is Alzheimer's disease, stick around. We're here to help.