Doctors stress the importance of an early diagnosis Alzheimer’s disease. Individuals are encouraged to see a specialist as soon as possible if: memory problems and other signs of Alzheimer’s begin interfering with daily activities. This is particularly relevant for those who have a family history of Alzheimer’s. Researchers now have enough evidence to assert that AD is indeed genetic and frequently runs in families.
Awareness of the early signs of Alzheimer’s is generally not self-evident. Instead, friends or family members usually notice these symptoms before the patient does and may gently suggest a trip to the doctor for a check-up. Symptoms that could indicate the onset of Alzheimer’s are subtle but definite and include:
- Memory loss that progressively worsens (frequently forgetting where the car is parked, misplacing important items like eyeglasses and keys or putting items in odd places instead of in their normal places)
- Inability to quickly recall words for everyday items (words like hairbrush, coffee pot, bananas or bathtub may not come as easy anymore to the patient)
- Problems learning new things or performing everyday routines (someone in the early stages of Alzheimer’s may repeat questions, exhibit issues with maintaining focus and attention and becoming agitated over a change in routine)
- Physicians involved in diagnosing Alzheimer’s for a family member may ask those who are close to the patient whether they have noticed behavioral changes such as apathy, unprovoked emotional outbursts, irritability, lack of energy and verbalizing thoughts in public that are inappropriate
More on the early diagnosis of Alzheimer’s…
Who is Qualified to Make a Diagnosis of Alzheimer’s Disease?
Usually the first medical professional a person suffering symptoms of Alzheimer’s sees is the family doctor. If the doctor suspects something may be seriously wrong, he or she will request blood work be sent to a laboratory to test for the presence of nutritional, metabolic, endocrine or systemic disorders that may be causing dementia symptoms.
Problems stemming from hyper- or hypothyroidism, kidney or liver disease, deficient vitamin B12 levels, medication toxicity and unregulated electrolytes can all contribute to memory and behavioral changes similar to Alzheimer’s dementia.
Other disorders that mimic dementia and make diagnosing Alzheimer’s difficult include:
- Vascular dementia–usually the result of strokes or cerebrovascular diseases
- Brain tumors that press on areas of the brain involved in memory, attention and judgement
- Subdural hematomas received because of trauma to the head
- Depression–attention deficits, confusion, apathy and memory impairment are all symptoms of depression
- Parkinson’s and Huntington’s disease accompanied by Lewy body dementia
- Creutzfeldt-Jakob Disease–a rare, genetic disorder predominantly affecting the brain
- Frontotemporal dementia–a non-genetic form of dementia
Neurologists, psychologists and psychiatrists are often involved in diagnosing Alzheimer’s disease by using criteria adapted from the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association). Medical professionals base a diagnosis on the following:
- The patient exhibits marked deficits in at least two areas involving cognition (perception, judgment, reasoning and awareness)
- There has been a progressive worsening of cognitive and memory abilities
- Consciousness remains undisturbed
- Evidence of dementia has already been established by several objective testing methods
- The patient is between 40 and 90 years old
In addition to blood and urine analysis, doctors will test motor and reflex skills while closely observing the patient during the examination for signs of distress, confusion or difficulties with speech. Written and oral tests such as mental status exams or the St. Louis University Mental Status Examination are routinely given to people with dementia symptoms as well.
Use of Biomarkers for the Early Diagnosis of Alzheimer’s Disease…
A biomarker is a detectable, naturally occurring substance within the body, such as glucose, neurotransmitters, cholesterol or cerebrospinal fluid that may indicate the presence of a disease if the amount of the biomarker is too high or too low. For example, glucose represents a definitive biomarker for diabetes while high cholesterol may predict a heart disease condition. Two biomarkers have been identified with helping in diagnosing Alzheimer’s–one that reveals the amount of beta-amyloid in the brain and one that tells doctors the extent of nerve cell damage in the brain.
Brain Imaging Scans
Magnetic resonance imaging scans produce images that reveal whether significant shrinkage of the brain is occurring, one of the signs of Alzheimer’s disease. Researchers are also looking into the possibility that an MRI scan may be able to detect atrophy associated with the onset of early dementia before symptoms start affecting cognition.
Confirming a Diagnosis of Alzheimer’s
Although medical professionals can generally guarantee a 90 percent accuracy rate when diagnosing Alzheimer’s, the only way to positively confirm a diagnosis of AD is by performing an autopsy. Plaques and tangles that are indicative of Alzheimer’s can be clearly seen during an autopsy, as well as shrinkage of the hippocampus and the brain’s ventricles. This kind of absolute confirmation is especially important to families that may carry the Alzheimer’s gene so that initiation of preventative measures may help reduce the risk of other family member’s developing the disease.