Afraid You May Have Early Stage Alzheimer’s? Why It Makes Sense to be Tested
It wasn't all that long ago when most people, including many doctors, felt that there really wasn't much point in diagnosing Alzheimer's disease until later stages when symptoms were out of control, so to speak. There are many types of dementia, and so, the thought process went, if you couldn't cure them, what difference did it make what kind it was? Besides, the only way Alzheimer's could be truly determined was by an autopsy.
Well, attitudes have changed. While we aren't likely to see a cure for Alzheimer's disease for years, there has been progress, especially in the area of slowing the progression of the disease. The person who has developed mild symptoms may stay active and productive for a longer time if he or she is diagnosed early and treated with one of the drugs available, such as Donepezil (sold as Aricept), or often a combination of drugs such as Donepezil and Memantine (sold as Namenda).
These drugs, like most, have side effects. Some people find the side effects hard to handle, but often changes in dosage, or just using one of the drugs rather than a combination, will mitigate the side effects and make it possible to stave off the worst of the disease, gaining valuable time for the whole family affected by the disease.
Alzhiemer's is, indeed, a family disease. The person suffering from it views it from the inside, so well described in Richard Taylor's book, Alzheimer's From the Inside Out.
The family watches as the person whom they know and love changes before their eyes. Each stage of Alzheimer's disease takes more of that person from them. Having extra time to be together as a family, enjoy friends, travel and plan for the future is valuable. Every day the worst symptoms of the disease can be delayed is precious. Thus, getting diagnosed early is encouraged by every Alzheimer's group I've ever encountered, as well as most people who have family members with the disease.
The family doctor may be the person to start with, as you should be screened for many different health problems that can imitate dementia. You should have all of your medications checked over by one doctor, even if you see several doctors. I would suggest a double check by your pharmacist. Side effects of medications and/or over medication are often mistaken for dementia, when in reality it's the medications themselves causing the problems.
If your physical health is good, and your doctor just chalks up your concerns as normal aging, it's time to see a specialist. There are various psychiatric disorders that can mimic Alzheimer's disease, so the next step may be to see a psychiatrist. Sometimes getting to see the right doctor is tricky so ideally, at this point, you would find a geriatrician to coordinate your care, unless you are quite young and worried about early on-set Alzheimer's. Then you'd stay with your primary doctor to coordinate care. If your doctor doesn't cooperate, change doctors. The main idea is to rule out other disorders that can mimic dementia.
A specialist may give you one or more tests for starters. The Mini-Mental State Examination (MMSE) is the most often used. The test is a research-based set of questions that scores a person's general level of impairment, if there is impairment.
It assesses memory, concentration and other cognitive skills. While the MMSE seems simple on the surface, but should be scored by a trained clinician.
You should also be interviewed about your life in general. Your level of education and what you did for a living will make a difference in test scores, but it also will give the doctor clues as to how far away from what would be expected to be your own normal mental ability you are. Your family will also be interviewed. What changes have they seen? What were you like before the changes? Everything from work to family life to hobbies should be talked about.
You may be given a brain scan, likely a PET scan, which will show lit up areas of your brain so doctors can determine if some areas are damaged, and if so, what areas they are, and how widespread the damage is.
It's not really known when Alzheimer's actually begins, but if you are showing some troubling symptoms, you are likely in an early stage and Alzheimer's is still hard to pin down early. That's why cumulative information your doctor collects is so important. It's the fully picture that is likely to determine the final diagnosis.
An extremely helpful article from the Medical College of Wisconsin titled, "Best Practices Identified for Early Alzheimer's Detection," would make good reading for anyone wanting a doctor's opinion about their memory problems, or that of a family member. The article lists different tests used for screening and why different ones may be chosen. It also stresses that the opinion of family and long-time friends is key to helping the physician decide is there is, indeed, impairment, and if there is impairment, if it isAlzheimer's or something else.
The bottom line is that when family or friends are concerned about you, or you are concerned about yourself, it's time to get a checkup. First get a complete physical, including a review of all of your medications and their possible side effects and interactions. Then, see if a psychological checkup is in order. Is depression something that runs in your family? Have you been under unusual stress for a prolonged period? These are things that could mimic dementia, but in reality need different treatment. After other reasons for your concern have been ruled out, and your psychiatrist or other specialist determines a need, then you would start the Alzheimer's testing phase.
In the past, people were afraid to be tested for Alzheimer's since nothing could be done. Now, it's still scary. It's easy to avoid testing because you don't want the "bad news." However, now that we know that there is a positive side to early diagnosis, hopefully people will get in and get tested. The time gained, through early intervention, will give families precious time that that denial would have stolen from them.
Check list of tests on Ouralzheimers.com here.