In a recent SharePost someone asked about how Alzheimer's disease is diagnosed. So I am going to look briefly at how that diagnosis is made, who decides on the diagnosis, what tests need to be done and how you can find some more information about diagnosis on this site.
Types of Dementia
When dementia is suspected the first step is to get a more accurate diagnosis of the type of dementia, so that appropriate treatments can be offered to the patient. Alzheimer's disease is the most common form of dementia but there are other disorders that can lead to dementia. These include Pick's, Vascular, Creutzfeldt-Jakob disease (CJD), Lewy Body, Frontotemporal dementia, Parkinson's related dementia. Infectious diseases such as HIV and AIDS, meningitis, advanced neurosyphilis can also lead to dementia. Dementia is also sometimes associated with drug abuse or toxins such as mercury, carbon monoxide and lead.
A skilled physician will be able to diagnose the cause of Alzheimer's-like symptoms with over 90% accuracy.
Click here for more information about the different types of dementia.
Diagnosis of Alzheimer's Disease
A diagnostic workup will include the following:
- A medical history. This should include questions about past illnesses and diseases diagnosed and treated, prior injuries, any surgical interventions, and any current chronic conditions.
- Medications history. This includes current medications and dosage, medications taken for passed medical conditions, any incidence of drug allergies or drug misuse.
- Neurological examination. This will include an examination of the motor system (movement), an evaluation of reflexes, coordination, and sensory functioning. The examination should be able to detect problems with the nervous system that may be causing problems with thinking and behavior.
- Premorbid history. In other words how someone functioned prior to the occurrence of disease.
- Complete physical examination to assess hearing, vision, blood pressure, pulse, and other basic indicators of health and disease.
- Preliminary evaluation of current mood.
Click here for more comprehensive information about what physicians are looking for, and what they are trying to eliminate, in order to make an accurate diagnosis of Alzheimer's disease.
Tests for Alzheimer's Disease
There are a number of tests. They include the following:
- Mental status examination. One of the key diagnostic tests for dementias such as Alzheimer's is the Mental Status Examination (MSE). The doctor/clinician makes judgments on the way the patient is functioning in a number of key areas. These components of the MSE cannot be judged in isolation. Each aspect will contribute to a diagnosis. The MSE will assess memory, concentration, and other cognitive skills. Based on a series of questions and tests, points are achieved when they are answered correctly. A maximum 30 points is possible with scores of 26 or less generally being reported by people with Alzheimer's.
- The Clock Test. This is a simple test can be used as a part of a neurological test or as a screening tool for Alzheimer's and other types of dementia. Research varies on the ability of the Clock Drawing test to differentiate between, for example, vascular dementia and Alzheimer's disease
- Laboratory tests usually include urine and blood tests to establish whether such things as diabetes, infections, heart disease are present.
- Imaging procedures such as a computed tomography (CT) scan, a magnetic resonance imaging (MRI), or a positron emission tomography (PET) scan can identify changes in brain structure or size indicative of Alzheimer's. The tests give a detailed picture of the brain and can see if someone has blood clots, tumors, has had a stroke or other abnormalities that might account for Alzheimer's type symptoms.
Who Can Diagnose Alzheimer's Disease?
There are many different health professionals who can diagnose or can contribute to a diagnosis of Alzheimer's disease. Usually the first person from who we seek help is a primary care physician (your family doctor). They will be able to refer someone for further tests and consultations for an accurate diagnosis. The choice of specialist depends on a number of factors that include medical presentation of the individual. It may be to one or more of the following-
- A Gerontologists-They specialize in the study and diseases of aging.
- A psychiatrist- They specialize in mental, emotional, and behavioral disorders.
- A Neurologist- Specializes in diseases of the nervous system such as Alzheimer's, Parkinson's or strokes.
- A Neuropsychologist. Specializes in brain-behavior relationships. They undertake neuropsychological testing to determine the type and level of impairment. Their goal is to help the individual manage the symptoms through medical treatments or behavior management.
An Alzheimer's diagnosis can only be 100% accurate from autopsy, but as mentioned previously, we can get up to an 90% accurate diagnosis from the tests and examinations I have just outlined.
Published On: September 24, 2008