Finding
Out If It Is Alzheimer Disease
 Alzheimer's disease is a progressive, degenerative disease.
Symptoms include loss of memory, judgment and reasoning;
difficulty with day-to-day tasks; and changes in communication
abilities, mood and behaviour. If you notice any
of these symptoms, it is important to see your
doctor.
Why
find out?
Symptoms
of Alzheimer's disease can be similar to symptoms of other
conditions such as depression, thyroid or heart disease,
infections, drug interactions or alcohol abuse.
Finding
out the cause of the symptoms can help people:
- understand
the source of the symptoms
- get
the proper care, treatment and support
- plan
for the future
Making
the diagnosis
There
is currently no single test that can tell if a person has
Alzheimer's disease. The diagnosis is made through a systematic
assessment which eliminates other possible causes. Until
the time when there is a conclusive test, doctors may continue
to use the words "probable Alzheimer's disease. "
However, you should be aware that doctors making this diagnosis
are accurate 80 to 90 per cent of the time.
Making
the diagnosis can take time. The diagnosis can be made in
a family doctor's office, a memory clinic or a hospital.
The doctor may or may not feel that the person needs to
see a number of health-care professionals to help make the
diagnosis. These may include a psychologist, psychiatrist,
neurologist, geriatrician, nurse, social worker or occupational
therapist. They will look for problems with the person's
memory, reasoning ability, language and judgment, and how
these affect day-to-day function.
The
process involves:
Medical
history
Both the individual and family members or friends will be
asked questions regarding the person's symptoms now and
in the past. There will be questions about past illnesses
and about family medical and psychiatric history.
Mental
status exam
This part of the process tests the person's sense of time
and place as well as the ability to remember, express herself
and do simple calculations. It may involve exercises such
as recalling words and objects, drawing and spelling, and
questions such as "What year is it?"
Physical
exam
To help rule out other causes, a physical exam will be done.
The doctor will look for heart, lung, liver, kidney or thyroid
problems that may be causing the symptoms. To evaluate whether
other nervous system disorders are causing the symptoms,
the doctor will test muscle tone and strength, co-ordination,
eye movement, speech and sensation.
Laboratory
tests
A number of tests will be done. Detailed blood work will
be ordered to help detect problems such as anemia, diabetes,
thyroid problems or infections that might be contributing
to the symptoms.
Other
tests such as X-rays and EEG's (electroencephalogram) may
be used to determine the source of the problem. In some
centres, scans may be used. The following may be recommended,
but are not always necessary for a diagnosis:
CT
(computerized tomography) scan and MRI (magnetic
resonance imaging) take images of the brain.
SPECT
(single proton emission computed tomo-graphy) shows how
blood is circulating to the brain.
PET
(positive electron tomography) shows how the different areas
of the brain respond during certain activities such as reading
and talking.
Psychiatric
and psychological evaluations
A psychiatric evaluation may be helpful in ruling out other
illnesses such as depression which can cause symptoms similar
to Alzheimer's disease. Neuro-psychological testing can evaluate
memory, reasoning, writing, etc.
Preparing
for the assessment
On
the day of the appointment, it will be useful to have the
following information on hand. Writing this information
down beforehand can be helpful.
Things
you will be asked:
- What
symptoms have been noticed?
-
When did they first appear?
-
How have the symptoms changed over time?
- What
other medical conditions exist?
-
What medications are currently being taken (both prescription
and over-the-counter)?
- What herbal remedies and/or dietary supplements are
currently being taken?
- Is
there a family history of Alzheimer's disease or
psychiatric conditions?
Things
you may want to ask:
-
Which tests will be performed? What is involved in the
tests?
-
How long will the tests take?
-
How long will it take to learn the results?
-
How are the results communicated? Who will be involved?
The
family's role
Sometimes
the person experiencing the problems will go to see her
doctor. For others, the family will play a role in alerting
the doctor of a problem.
Tips
to lend a hand:
- Make
the appointment for the person
-
Help with transportation
-
Share this brochure with other family members
-
Offer to accompany the person to appointments and tests
-
Help prepare information for the first appointment
-
Appreciate that this can be an unsettling time for the
person and provide emotional support
-
Have patience; it can take a long period of time to arrive
at a diagnosis
If
the diagnosis is Alzheimer's disease
You
may want to ask:
- What
does the diagnosis mean?
- What
can be expected over time?
- What
care will be needed and is available, now and in the future?
- What
treatment is available? What are the risks and benefits?
- What
resources are available in the community to help?
- Are
there any experimental drug trials to participate in?
- When
is the next appointment?
Finding
support
Please
call your local Alzheimer
Society at any time in the process for additional information,
community referral or support.
[This
information is also available in a brochure from your local
Alzheimer Society or you can download
the brochure from this site.]
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