Diagnosing Alzheimer’s

Video:  “ViewFinder Fading Away - Alzheimer's Diagnosis”  Experts from Sutter Health, U.C. Davis, and Kaiser Permanente explain the process of diagnosing Alzheimer's disease, and differentiating it from other forms of dementia.

The diagnosis of Alzheimer’s disease is one of ‘exclusion’ – you exclude other conditions first that may be responsible for producing the symptoms of memory loss, confusion, personality change, etc.  There is no one “test” to determine Alzheimer’s disease.
Since there are numerous conditions that mimic the symptoms of Alzheimer’s disease, a thorough evaluation is recommended in order to rule out any condition that may be treatable. A neurologist, memory disorder clinic, or hospital with a specified geriatric program can do effective evaluations.

A typical evaluation of a patient with suspected Alzheimer’s disease generally includes the following:
  • Ask the person and a family member or friend questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
  • Conduct tests of memory, problem solving, attention, counting, and language.
  • Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
  • Perform brain scans, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to rule out other possible causes for symptoms such as tumors, and strokes.
These tests may be repeated to give doctors information about how the person’s memory and other cognitive functions are changing over time. Tests can also help diagnose other causes of memory problems, such as mild cognitive impairment and vascular dementia.

After a thorough evaluation, and if the above tests are performed and prove negative, a diagnosis of “probable Alzheimer’s” may be made.  If your primary care doctor suspects mild cognitive impairment or possible Alzheimer’s, he or she may refer you to a specialist who can provide a detailed diagnosis, or you may decide to go to a specialist for further assessment. You can find specialists through your health provider, memory clinics and centers, or through local organizations or referral services. Specialists include:
  • Geriatricians, who manage health care in older adults. They know how the body changes as it ages and whether symptoms indicate a serious problem.
  • Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
  • Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
  • Neuropsychologists, who can conduct tests of memory and thinking.
  • Memory clinics and centers, such as the University of California at Davis Alzheimer’s Disease Research Center (link to http://www.ucdmc.ucdavis.edu/alzheimers/), offer teams of specialists who work together to diagnose the problem. Tests often are done at the clinic or center, which can speed up diagnosis.

You may also want to get a second opinion. Diagnosis of memory and thinking problems can be challenging. Subtle signs and symptoms may be overlooked or unclear. Getting a second opinion helps confirm the diagnosis. Most doctors understand the benefit of a second opinion and will share your records if you permit. A specialist can refer you to another doctor for a second opinion, or you may decide to find one yourself.

Alzheimer’s/Dementia Facts: