Don't Assume It's Alzheimer's Until You Have An Expert's Diagnosis

  • It must be Alzheimer's. I can't believe how often I hear people say their parent has Alzheimer's disease. When I sympathize and ask questions about how they got the diagnosis, it's often just assumed that the type of dementia that the patient is showing is Alzheimer's disease.


    Maybe that is the price we pay for increased awareness. However, people - family members and even some physicians - seem to be jumping to the "it's Alzheimer's" conclusion before the patient in question has had a thorough workup by a qualified physician or team of physicians. The key word here is qualified.


    A colleague of mine has been keeping me informed about her father and his Alzheimer's disease and the effect of a stroke he'd had. When I see her on my way to check my work mail, I'll ask how her dad is doing. I did this over the Christmas holiday, as is natural. I knew the family was bringing her dad to their home.

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    I asked how he did with new surroundings. She said he was fine. She had mentioned, on one occasion, that she thought he was in mid-stage Alzheimer's. Yet, when I inquired, she said he didn't have any anxiety about leaving his familiar place in the nursing home, nor was he confused about going to my friend's home. I realize that all Alzheimer's patients don't travel the same journey, but this seemed odd for mid-stage Alzheimer's disease.


    I asked her a couple of times after these conversations if she was sure her dad had Alzheimer's disease. It was obvious, from some of the things she told me, that her dad did have some form of dementia. And I'm not a medical person, so I'm very careful about interfering, as long as the person is seeing a doctor. Yet, something didn't seem right to me.


    My friend decided to take her father to a psychiatrist at the veteran's hospital here in town. After the visit, I asked her how it went. She said the doctor didn't say much, but the office would call.


    I was shocked, as I was driving for an appointment on my day off from work, to receive a call from this colleague. We aren't social friends, so I thought something at work needed my attention. It turned out that she was just excited to tell me her dad didn't have Alzheimer's disease. It was a type of vascular dementia that occurred due to his stroke.


    No type of dementia is good news. But surely a careful diagnosis is vital to provide the best treatment for the patient. It's also vital for the family. They want to research. They want to know what to expect at each stage. They want to be informed. And they want to trust their loved one's doctor.


    If this were the only case I'd run into, I wouldn't have thought so much of it. Yet, I just answered an e-mail from an internet reader who'd come across my name. She had serious questions about some of her dad's medications. I did something I rarely do, and called her, as she left her number and was waiting for a doctor to call her. It seemed urgent.


    As we chatted, she talked about her dad's Alzheimer's disease. I asked if he was diagnosed. She said not really, though he had a sister with Alzheimer's disease, so his doctor assumed that was what was going on. I understand the leap of logic, but I suggested he be tested by a qualified physician, anyway. Who knows? Maybe this is a reversible dementia caused by a medication he is on. Maybe it's a vitamin deficiency. Maybe, since he has had a stroke, it is vascular dementia. Doesn't every patient deserve a thorough exam and a unique diagnosis? She agreed and was making an appointment.


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    It must be Alzheimer's. Really? Maybe it is, but we need to be sure. The right treatment, and even the quality of life of the patient, may be at stake.


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Published On: January 31, 2008