If you are experiencing memory, judgment, or reasoning problems; difficulty with day-to-day functions; or changes in your mood or behavior, it is important to visit a physician to determine if you have Alzheimer's disease or another dementia.
- An early diagnosis is important
- Information your physician needs to know
- Questions to ask your physician about testing
- Common tests
- Understanding the diagnosis
- Questions to ask your physician about the diagnosis
- Finding additional help
- Telling others about the diagnosis
- An early diagnosis is important
Recognizing symptoms early and obtaining an accurate diagnosis is extremely important because it may:
- maximize the quality of your life
- resolve anxiety
- give you a greater chance of benefiting from existing treatments
- give you more time to plan for the future
Another important reason to get a diagnosis is to identify the actual cause of the dementia so that you receive the proper care. Dementia related to depression, drug interaction, thyroid problems, and certain vitamin deficiencies, for example, may be reversible if detected early. Other causes of dementia include strokes, Huntington's disease, and Parkinson's disease and are not reversible.
- Information your physician needs to know
You and a family member can help by providing the physician key information, including:
- changes that have occurred in yourself, possibly documented in the form of a journal
- signs of the disease beyond memory loss and personality and mood changes
- a list of all the medications and herbal remedies you are taking
- Questions to ask your physician about testing
- Which tests will be performed, and what is involved?
- How long will the tests take?
- How long will it take to learn results?
- Common tests
There is no one diagnostic test that can detect if a person has Alzheimer's disease. Standard clinical methods combine physical and neuropsychological testing with caregiver input and the physician's judgment, and the diagnostic process may take more than one day. New diagnostic tools and criteria make it possible for physicians to make a positive clinical diagnosis of Alzheimer's with around 90 percent accuracy.
The diagnostic process will involve your primary care physician and possibly other specialty physicians, such as a psychiatrist or neurologist.
Evaluations commonly performed during a diagnosis include:
- A medical history, which provides information about current mental or physical conditions, prescription drug intake, and family health history.
- A mental status evaluation that assesses your sense of time and place and your ability to remember, understand, communicate, and do simple calculations. In early-stage Alzheimer's, screening of mental status may not detect symptoms.
- A physical examination, which includes the evaluation of your nutritional status, blood pressure, and pulse.
- A neurological examination that tests the nervous system (brain and spinal cord) for evidence of other neurological disorders. A magnetic resonance imaging (MRI) study of the brain is used to search for other possible causes of dementia (e.g., stroke). In early stages of Alzheimer's the results are often "normal" or "unremarkable."
- Laboratory tests, such as blood and urine tests, to provide additional information about problems other than Alzheimer's that may be causing dementia.
- Neuropsychological evaluations, which test memory, reasoning, vision-motor coordination, and language function and may provide the only evidence of dementia, especially in the early stages.
- Psychiatric evaluation, which provides an assessment of mood and other emotional factors that could mimic dementia or may accompany Alzheimer's disease.
- Understanding the diagnosis
A diagnosis of Alzheimer's usually falls into one of the following three categories:
- A diagnosis of probable Alzheimer's indicates that the physician has ruled out all other disorders that may be causing dementia and has come to the conclusion that symptoms are most likely the result of Alzheimer's disease.
- A diagnosis of possible Alzheimer's means that Alzheimer's disease is the primary cause of dementia symptoms but that another disorder may be affecting the known progression of Alzheimer's, so that the disease process is somewhat different from what is seen normally.
- A diagnosis of definite Alzheimer's can be made only at the time of autopsy and requires examination of brain tissue. A brain autopsy is the only way to diagnose the disease with 100 percent accuracy and can provide a vital record for your family's medical history.
- Questions to ask your physician about the diagnosis
- What does the diagnosis mean?
- Are additional tests needed to confirm the diagnosis?
- What changes in behavior or mental capacity can I expect over time?
- What care will I need, and what treatment is available?
- What else can be done to alleviate symptoms?
- Are there clinical trials being conducted in my area?
- Finding additional help
Families usually turn to their primary care physicians first to diagnose Alzheimer's. Unfortunately, many physicians have not had the proper training to manage the multiple health care problems in older adults or to recognize possible signs of dementia in individuals below the age of 65. If you aren't getting the answers you need from your primary care physician, you may need to request a referral to a specialist in Alzheimer diagnostics.
In Nebraska, contact our Lincoln or Scottsbluff offices for locations of Memory Disorders and Alzheimer's Assessment Clinics. Contact our Kansas office for a list of physicians with an emphasis in Alzheimer's care or diagnosis. For resources in Wyoming, contact our Cheyenne or Scottsbluff office.
While we cannot provide you with a direct referral, we can give you a list of available resources and some questions to ask that will help you make an informed decision.
- Telling others about the diagnosis
When you learn that you have a diagnosis of probable Alzheimer's disease, you may hesitate to tell others. You may be coming to terms with the diagnosis yourself or you fear that others may feel uncomfortable around you.
It's true that some people in your life may react by keeping their distance. But others will take the news in stride and offer their help.
Moreover, telling others what you know allows you to make medical, legal, financial, and personal decisions now for the future.
When you talk with family and friends:
- Explain that Alzheimer's disease is not a normal part of aging but a disease of the brain that results in impaired memory, thinking, and behavior.
- Be sure they understand that the disease is a medical condition and not a psychological or emotional disorder.
- Share educational information on Alzheimer's disease. The more you, your family, and friends learn about the disease, the more everyone will be able support one another.
- Be candid about how you feel about your diagnosis and allow other family members to do the same.
- Assure friends that although the disease will change your life, you want to continue enjoying their company.
- Let friends know when and how you may need their help and support.
When you talk with children or teens:
- Explain that Alzheimer's is a disease that affects your brain and your memory.
- Reassure children that they cannot "catch" the disease from you.
- Talk openly about the changes you may be experiencing as a result of the disease.
- Be candid about personality and behavior changes. For example, you may forget things, such as their names, and say and do things that may embarrass them. Assure them that this is not their fault or intentional but a result of the disease.
- Stress that they are loved no matter what the future holds.
When you talk with your employer or coworkers:
- Explain that you have a neurological disorder that affects your memory and thinking and that you may find job-related tasks more difficult to perform as the disease advances.
- Discuss with your employer the possibility of switching to a position that better matches your abilities and strengths, reducing your work hours, applying for disability benefits, or exploring early retirement options.
- Decide with your employer who else will need to know about your diagnosis, such as coworkers and clients whom you work with closely.
- Tell coworkers that you may become frustrated with yourself, or frustrating to them, when you have trouble recalling information or finding the right words.
