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Diagnosis

Introduction
Finding the right doctor
Evaluating mood and mental status
Physical exam and diagnostic tests
Neurological exam
When the diagnosis is Alzheimer's

Introduction

Often people with severe memory loss or other possible warning signs of Alzheimer's are not aware of the problem. They may resist following up on their symptoms. Signs of dementia may be more obvious for family members or friends. While there is no single test that proves a person has Alzheimer's, a doctor can diagnose Alzheimer's with more than 90 percent accuracy.

Finding the right doctor

The first step is to find a doctor you feel comfortable with. Your local Alzheimer's Association can help.

There is no single type of doctor who specializes in diagnosing and treating memory loss or Alzheimer's. Many people contact their regular primary care doctors or internists about their concerns. Primary care doctors often oversee the diagnostic process and provide treatment themselves.

In many cases, the primary care doctor may refer a patient to a specialist, such as a:

  • Neurologist, who specializes in diseases of the brain and nervous system
  • Psychiatrist, who specializes in disorders that affect mood or the way the mind works
  • Psychologist with advanced training in testing memory, concentration, problem solving, language and other mental functions


Evaluating mood and mental status

Mental status is tested to give the doctor a general idea of how well the mind is working. This testing gives an overall sense of whether a person:

  • Is aware of having symptoms
  • Knows the date, time and where he or she is
  • Can remember a short list of words, follow instructions and do simple calculations

The doctor may ask the person his or her address, what year it is or who is serving as president. The individual may also be asked to spell a word backward, draw a clock or copy a design.

The doctor will assess mood and sense of well-being to detect depression or other illnesses that can cause memory loss and confusion.

Physical exam and diagnostic tests

The doctor will perform procedures to assess the person's overall health like evaluating diet, checking blood pressure or listening to the heart. Blood and urine samples will be collected, and other laboratory tests may also be ordered.

Information from these tests can help identify disorders such as anemia, diabetes, kidney or liver disease, certain vitamin deficiencies, thyroid abnormalities, and problems with the heart or blood vessels. All these conditions may cause confused thinking, memory problems or other symptoms similar to dementia.

Neurological exam

A doctor, sometimes a neurologist who specializes in disorders of the brain and nervous system, will closely evaluate the person for problems that may signal brain disorders other than Alzheimer's.

The doctor will also test the person's reflexes, balance, eye movement, speech and sensation. The doctor is looking for signs of small or large strokes, Parkinson's disease, brain tumors, fluid accumulation on the brain, and other illnesses that may impair memory or thinking.

The neurological examination may also include a magnetic resonance imaging (MRI) or computer tomography (CT). MRIs and CTs can reveal tumors, evidence of small or large strokes, damage from severe head trauma or a buildup of fluid. Medicare will cover a positron emission tomography (PET) scan as an aid in diagnosis in certain cases.

When the diagnosis is Alzheimer's

Once testing is complete, the doctor will review results and share conclusions. A diagnosis of Alzheimer's disease reflects a doctor's best judgment about the cause of a person's symptoms.

You may want to ask the doctor to explain:

  • Why the diagnosis is Alzheimer's
  • Where the person may be in the course of the disease
  • What to expect in the future

Find out if the doctor will manage care going forward and, if not, who will be the primary doctor. The diagnosing doctor can then schedule the next appointment or provide a referral.

A diagnosis of Alzheimer's disease is life-changing for both diagnosed individuals and their families. While there is currently no cure, treatments are available that may help relieve some symptoms.


Next: Treatments

Made possible with a grant from the Abbott Fund.

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