Learn which medical exams and screening tests may be needed before a clear diagnosis of Alzheimer’s disease can be made.
Diagnosing Alzheimer’s disease as early as possible can help patients and their families to better prepare for the progression of the disease. But diagnosing Alzheimer’s can be a complicated process, given that it is only one of a group of brain diseases known as dementia, meaning neurological disorders that rob the mind of its intellectual ability.
Alzheimer’s expert Malaz Boustani, MD, MPH, recommends that family members get a potential Alzheimer’s patient checked out, even if they just have a “gut feeling” something might be wrong. “That feeling in and of itself is a big red flag, and families need to get their loved one evaluated as soon as possible. If you have any doubt — even if it just crosses your mind — it’s worth investigating,” says Dr. Boustani, assistant professor at the Indiana University School of Medicine and a center scientist with the Indiana University Center for Aging Research.
Alzheimer’s Diagnosis: Finding a Doctor
If you or a family member needs to be evaluated for Alzheimer’s disease, medical experts say the first stop should be your primary care physician. Your family doctor will often coordinate the diagnostic process. If your doctor wants more input from a specialist, you could be referred to one of the following professionals:
- A geriatrician, a medical doctor who specializes in the care of elderly patients
- A neurologist, a medical doctor who specializes in diseases of the brain or nervous system and can assess different types of dementia
- A psychiatrist, a medical doctor who specializes in mental disorders and can diagnose a mood disorder, such as severe depression that may mimic Alzheimer’s symptoms.
- A psychologist, a licensed medical professional (a PhD or PsyD) who can test such mental functions as logic, memory, and concentration.
Boustani says that ideally, any specialist you see should have training in memory disorders and dementia. It can often be difficult, however, to find someone with those qualifications. “Our current health care system, unfortunately, doesn’t have enough memory-care practitioners capable of performing a full diagnostic assessment,” he says.
Screening Tests for Alzheimer’s
Currently, the only definitive way to diagnose Alzheimer’s disease is by looking at brain cells under a microscope after a person has died. But since that’s too late to do the person any good, physicians have come up with a battery of tests that can help determine the likelihood of an Alzheimer’s diagnosis. Experts believe that a skilled doctor using these tests can diagnose Alzheimer’s accurately in nine out of 10 cases.
Doctors can evaluate the possibility of Alzheimer’s disease by:
- Taking a medical history. During this process, the doctor will learn whether anyone in the patient’s family has suffered from Alzheimer’s or other forms of dementia. The doctor will also ask about any medications or illnesses that could cause side effects that resemble Alzheimer’s symptoms. Both the patient and their family must be involved in this step, since short-term memory loss is an early symptom in 75 percent of people with Alzheimer’s and family members may have to help provide key information.
- Administering a mental exam. A series of tasks will test the patient’s memory and problem-solving skills. Attention span is also assessed, as well as the ability to count and speak logically.
- Performing a thorough physical examination. This hands-on exam includes a general check-up as well as a neurological exam that tests things like muscle tone, reflexes, and coordination. The doctor will also order blood work and urine test(s), and may order other, more specialized testing such as an MRI or CT scan of the brain.
Alzheimer’s Diagnosis: Ruling Out Other Causes
Most of the aforementioned tests aren’t just used to look for Alzheimer’s disease. They’re also aimed at ruling out other conditions that could be interfering with a person’s memory. For example, problems with memory or concentration can stem from an emotional disorder. “You might have depression, which can include memory complaints,” Boustani says.
A person with symptoms common to Alzheimer’s also might be suffering from a brain tumor, or bleeding inside the brain caused by a bad fall or a stroke. In other cases, memory loss could be caused by different forms of dementia, by a reaction to a medication the person is taking for an unrelated illness, or even by a vitamin deficiency. The important thing is to undergo the screening process so you know what’s wrong and can address it appropriately, Boustani says.
As with most medical conditions, an earlier diagnosis can bring quicker treatment and help ease the stress of dealing with a new illness. If you have any concerns about your risk of Alzheimer’s, do not hesitate to contact your doctor. Together you can decide on what, if any, testing is best for you or a loved one.