Alzheimer’s Diagnosis

What should I do if I’m worried about memory loss or possible Alzheimer’s?

As people get older, it is common to forget more things, have more trouble finding the right words, or lose things more often. But, when changes in memory and thinking begin to affect a person’s daily life and activities, it is time to be concerned and to find out what the problem is.

If you are concerned about changes in memory and thinking or changes in senses, behavior, mood, or movement that do not seem normal in yourself or a family member, talk to a doctor.

A good place to start is with your primary care doctor. Although your doctor may not specialize in cognition problems, he or she might administer brief memory screening tests that can help detect problems. The doctor can do a complete exam to find out if a physical or mental health issue is causing the problem.

Another reason to start with your primary care doctor is that he or she has your medical history, which is important background information for a diagnosis. Your relationship with your primary care doctor also may help you talk about sensitive issues. Your doctor may know you well enough to spot changes in your memory and thinking. He or she can refer you to the right kinds of specialists.

How is Alzheimer’s disease diagnosed?

Doctors have several methods and tools to help them determine fairly accurately whether a person with memory problems has “possible Alzheimer’s disease,” “probable Alzheimer’s disease,” or some other problem. “Possible Alzheimer’s disease” means the symptoms may be from another cause. “Probable Alzheimer’s disease” means no other cause for the symptoms can be found. A definitive diagnosis of Alzheimer’s disease can be made only through autopsy after death.

To diagnose Alzheimer’s in a living person, a physician will:

  • ask questions about a person’s 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 skills
  • carry out medical tests, such as tests of blood, urine, or spinal fluid
  • perform brain scans, such as a computed tomography (CT) or positron emission tomography (PET) scan or a magnetic resonance imaging (MRI) test

These tests may be repeated to give doctors information about how the person’s health and memory are changing over time. Sometimes these tests help doctors find other possible causes of the person’s symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood-vessel disease in the brain can cause Alzheimer’s-like symptoms. Some of these other conditions can be treated successfully.

Such tests also can help diagnose other causes of memory problems. These problems include mild cognitive impairment and vascular dementia. Mild cognitive impairment is a medical condition that causes people to have more memory problems than other people their age. Vascular dementia is a medical condition caused by small strokes or changes in the brain’s blood supply. For more information, see Understanding Memory Loss.

What are other options for assessment and diagnosis?

If the primary care doctor suspects mild cognitive impairment (MCI) 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 memory clinics and centers or through local organizations or referral services. Some types of 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 thinkingMemory clinics and centers, including Alzheimer’s Disease Research Centers, offer teams of specialists who work together to diagnose the problem. For example, a geriatrician can look at your general health, a neuropsychologist can test your thinking and memory, and a neurologist can use scanning technology to “see” inside your brain. 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 to confirm the diagnosis. Most doctors understand the benefit of a second opinion. They 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.

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