How is Alzheimer?s Diagnosed? Doctors to See and Tests to Have

Last Updated on Tuesday, 6 April 2010 11:50 Written by Natural Health Team Tuesday, 6 April 2010 11:50

Alzheimer’s disease is a complex and complicated illness, and its symptoms are frequently indicative of other disorders as well. As a result, the diagnostic process for the disease can be messy and complicated.

Currently, the only definitive way to diagnose Alzheimer’s disease is to examine brain tissue for plaques and tangles. Unfortunately, so far, this can only be done in an autopsy. So you might be wondering “how is Alzheimer’s diagnosed?”

Well, doctors must conduct a thorough examination so that they can rule out other possible causes of the symptoms you are experiencing. A diagnosis can be considered “possible” if all other causes cannot be ruled out. It can be considered “probable” if all other causes have been ruled out.

Fortunately, specialists with extensive experience working with Alzheimer’s patients can diagnose Alzheimer’s with 80-90% certainty.

Early Diagnosis – Don’t Waste Time Before Seeing a Doctor

According to Dharma Singh Khalsa, M.D., President and Medical Director of the Alzheimer’s Research and Prevention Foundation, it is important that you go for a diagnostic examination as soon as symptoms appear. Dr. Khalsa has found that many of the treatments currently available work best when an early Alzheimer’s diagnosis is made.

There are many other advantages to having Alzheimer’s diagnosed as early as possible.

First, early diagnosis helps patients and families plan for the future. It gives them time to discuss care options while the patient can still be part of the decision-making process. It also gives the patient time to get financial affairs in order while his or her mental functioning is still at a high level.

Second, early diagnosis allows you to gain access to the Alzheimer’s medications that are currently available. Several drugs have been approved by the FDA to treat Alzheimer’s symptoms, but they are generally more effective when taken in the early stages of the disease.

Third, early diagnosis allows you to participate in experimental Alzheimer’s drug and treatment studies. Right now, more than 200 clinical studies are underway testing new drugs and treatment methods. Most of these studies prefer to work with Alzheimer’s patients in the earliest stages of the disease.

Doctors to See and Tests to Have

Most people usually go to their general care physician first. This is understandable – we generally feel more comfortable speaking to someone with whom we already have a relationship.

However, it is a good idea to consult a neurologist or someone who primarily works with Alzheimer’s patients when seeking an accurate diagnosis.

Since there is no one test to concretely determine whether you have Alzheimer’s disease, most neurologists will conduct a variety of tests to rule out other causes of your symptoms and to more confidently attribute your problems to Alzheimer’s.

The following should be part of your diagnostic evaluation:

1. Mini Mental Status Examination:

This generally consists of interviews and tests that are aimed at evaluating your level of cognitive functioning:  these tests assess learning, attention, language, memory, and reasoning ability. Other family members may also be interviewed to gain additional insight into recent changes in memory, behavior, and personality.

2. Medical History:

A questionnaire is used to understand past medical problems, injuries, illnesses, chronic conditions, and medications you are currently taking.

3. Mood Evaluation:

This assesses the presence of other issues such as anxiety or depression, which can cause Alzheimer’s-like symptoms.

4. Physical Exam:

This generally evaluates hearing, vision, blood pressure, and pulse rate.

5. Lab Tests:

Blood and urine tests are conducted to rule out other causes and conditions.

6. Neuroimaging:

This is generally done by an MRI or CAT scan. These tests let your doctor identify any abnormalities in your brain. They can help identify changes in brain structure that are commonly exhibited in Alzheimer’s patients. They can also show the presence of brain tumors, blood clots and strokes – this is very useful in helping to rule out other causes of poor mental functioning.

While doctors are still looking for a more conclusive test to definitively answer the question “how is Alzheimer’s diagnosed?”, current practices are very accurate, even if they are lengthy and time consuming.

Just make sure that your doctor is thorough and administers all of the evaluations listed above. And make sure your symptoms are diagnosed as soon as you notice them. An early diagnosis will lead to much better treatment of the disease.

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Alzheimers Care Today

Last Updated on Monday, 5 April 2010 11:50 Written by Natural Health Team Monday, 5 April 2010 11:50

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This publication reflects treatment approaches by providing clinically focused information on quality dementia care. The content is evidence- and experience-based, with a heavy focus on material that is of immediate practical use to nurses, rehabilitation professionals, and administrators…. More >>

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Alzheimer’s Disease: What Every Family Needs to Know

Last Updated on Sunday, 4 April 2010 11:49 Written by Natural Health Team Sunday, 4 April 2010 11:49

Alzheimer’s disease touches the lives of millions of Americans. Today, some 4.5 million Americans suffer from Alzheimer’s, and 1 in 10 families have a loved one afflicted with it. With no cure in sight, it is important for families to arm themselves with information about this devastating disease.

* Alzheimer’s disease begins slowly.

Like a stroke, Alzheimer’s kills brain cells. Unlike a stroke, however, Alzheimer’s does not strike suddenly. And, its effects are more far-ranging. Experts like to say that Alzheimer’s has an insidious onset. This means simply that the disease starts slowly and unfolds very gradually. So gradually, in fact, that the person who has Alzheimer’s may not realize that anything is wrong until a great deal of brain tissue has been destroyed.

* Early symptoms reflect what is happening inside the brain.

Alzheimer’s disease attacks tissue deep within the brain and spreads out to include all those regions associated with complex thinking and learning; those regions of the brain that make us uniquely human. As the path of destruction widens, individuals who have Alzheimer’s will eventually notice that their thinking skills are deteriorating. More often than not, they will notice that their memory is failing. But, it is not just a series of senior moments. Individuals stricken by Alzheimer’s will have more than a little difficulty finding the right words to express their thoughts and feeling. They may forget the names of familiar places and long-term acquaintances. They are likely to forget long standing appointments. To compensate for these everyday losses, they may withdraw from friends and avoid social gatherings. Their homes may become littered with notes and other reminders as they struggle to overcome their memory losses.

* Alzheimer’s disease affects personality and behavior.

Interestingly, even as problems accumulate, many individuals will actively deny their difficulties. Denial is a common way of coping in the earliest stages of Alzheimer’s. It is a defense mechanism that helps to preserve a sense of self-worth, which becomes increasingly fragile as thinking skills fail. Unfortunately, denial does not “work” forever or for everyone. When denial no longer works, some individuals sink into depression. Others may react with angry outbursts, even rage, in the face of everyday frustrations. It is especially common for individuals afflicted with Alzheimer’s to develop a kind of apathy. They lose interest in those things that used to bring them joy.

* Early signs of Alzheimer’s may go unrecognized by family members.

Families often engage in their own form of denial when it comes to Alzheimer’s in a loved one. Significant memory problems in their loved one may be dismissed as simply a part of getting old. As a result, family members often overlook the earliest signs of mental deterioration. They become concerned and seek outside help only after they begin to notice the more obvious changes in behavior or personality. By then, Alzheimer’s has probably progressed to the point where their loved one can no longer live independently.

* Families must be prepared for what is going to happen.

Whenever the diagnosis of Alzheimer’s is finally made, it is important for family members to understand that this is not a disease that can be cured or reversed. The fact is, individuals who have Alzheimer’s will spiral downward toward total care and, ultimately, death. It may take years, but individuals who have Alzheimer’s will eventually lose everything that defines their personhood. Among other things, their ability to communicate will continue to decline. They will lose the ability to dress and groom themselves. They will need assistance using the toilet. They may begin to wander and to experience hallucinations. In the final stages of the disease, individuals afflicted with Alzheimer’s will be unable to recognize a spouse or a child. Motor skills will decline so much that they will be unable to walk or to feed themselves. They will lose all control of bowel and bladder. Eventually, all body systems will shut down.

* Families must be willing to reach out for help.

Families need to think carefully about the amount of assistance they are willing and able to provide. Affection for the afflicted individual, as well as a sense of obligation, can initially blind family members to the harsh realities of caring for their loved one. Families must understand that the kind of care required will become more and more demanding. Worse, they will have to watch as the deterioration takes place. Among family caregivers, stress reactions can be quite severe and depression is very common. To cope, family caregivers must seek help from their larger community. The local Alzheimer’s Association should be their first stop. It is the best single resource available. The local Alzheimer’s Association can direct families to a variety of services and assistance. For example, many communities have respite programs to give families a short break from care giving. Adult daycare also may be available to provide care during the day while family caregivers continue with their regular jobs. Often times, special support groups are available to help caregivers deal with the depression and other negative emotions that can develop over time. In any case, families of persons afflicted with Alzheimer’s disease do not have to go it alone. Help is available.

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What If It’s Not Alzheimer’s?: A Caregiver’s Guide to Dementia

Last Updated on Friday, 2 April 2010 11:49 Written by Natural Health Team Friday, 2 April 2010 11:49

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What If It’s Not Alzheimer’s?: A Caregiver’s Guide to Dementia

Alzheimers Disease – Causes, Symptoms and Treatment

Last Updated on Thursday, 1 April 2010 11:49 Written by Natural Health Team Thursday, 1 April 2010 11:49

Alzheimer’s disease is a group disorders involving the parts of the brain that control thought, memory, and language. Alzheimer’s disease is becoming tragically common. It is estimated that there are currently 18 million people worldwide with Alzheimer’s disease. Dementia is a disease of the nervous system characterized by loss of certain mental abilities. This loss is severe enough to interfere with normal activities and lasts at least six months. Dementia is the term for the deterioration of brain function that results in loss of memory, reduced language skills, impaired reasoning and behavioural and emotional problems. As the disease develops, a person loses the ability to carry out familiar tasks, to reason, and to exercise judgment. Moods, personality, and ability to communicate may also be affected. People with AD typically die within eight years of their diagnosis. Some individuals may die within a year of diagnosis, others may live as long as twenty years.

Alzheimer’s disease is progressive, which means that symptoms worsen over time. Language difficulties also are common in people with Alzheimer’s disease. People with Alzheimer’s can lose their sense of time and place – they may, for example, get dressed in the middle of the night or walk off and get lost. New surroundings and new people may be confusing. The disease typically progresses to the stage where it is difficult for the patient to be understood by others or to understand others, and in the final stages, the patient is bedridden. Free radicals are another factor in the formation of tangles and plaques. Free radicals are very active chemicals that form in the brain and damage brain cells. Chemicals known as antioxidants react with and destroy free radicals. Unfortunately there is no cure for Alzheimer’s. However, drugs can help to slow down the progression or relieve some symptoms and delay the need for residential care. Other therapies and support are available.

Causes of Alzheimers Disease

The exect causes of alzheimers disease are currently not known. Alzheimer’s is caused by a loss of brain cells, as well as changes in the cerebral cortex. Free radicals are another factor in the formation of tangles and plaques. Free radicals are very active chemicals that form in the brain and damage brain cells. Chemicals known as antioxidants react with and destroy free radicals. Another risk factor is heredity. People whose family members have had AD are more likely to develop Alzheimer’s disease than those whose families do not have this history. People who have hypothyroidism or have experienced head injuries are also at relatively high risk for AD. Environmental factors have sometimes been proposed as possible causes for Alzheimers disease.

Symptoms of Alzheimers Disease

The earliest symptom of Alzheimer’s disease is memory loss. Memory loss by itself is not an indication that a person has Alzheimer’s disease. Some memory loss is a natural part of growing old. People with Alzheimer’s can lose their sense of time and place – they may, for example, get dressed in the middle of the night or walk off and get lost. In early stages of the disease, family or friends may notice changes in behaviour. As the disease progresses, memory loss gets worse and some people have difficulty in learning new skills. Changes in behaviour may become more obvious, with people saying or doing things that are out of character. Some people become depressed because they realise what is happening to them. During the late stages of the disease, people with Alzheimer’s may become totally dependent on others for their care. Walking can become difficult and urinary incontinence may develop.

Treatment of Alzheimers Disease

There is currently no cure and virtually no medical treatment for Alzheimer’s disease. However, drugs can help to slow down the progression or relieve some symptoms and delay the need for residential care. A type of drug called cholinesterase inhibitors are used for people with moderate Alzheimer’s disease. They work by reducing the breakdown of the neurotransmitter acetylcholine, levels of which are low in Alzheimer’s. There are three such drugs available: donepezil (Aricept), rivastigmine and galantamine. Another drug, memantine, was launched for people in the late stages of Alzheimer’s. Sometimes anti-depressant medicines are prescribed to help treat the depression that can be associated with Alzheimer’s disease. Some people may benefit from anti-psychotic medicines.

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