Not everyone experiencing memory loss or other possible Alzheimer’s warning signs recognizes that they have a problem. Signs of dementia are sometimes more obvious to family members or friends.
The first step in following up on symptoms is finding a doctor with whom a person feels comfortable. There is no single type of doctor that specializes in diagnosing and treating memory symptoms or Alzheimer’s disease. Many people contact their regular primary care physician about their concerns. Primary care doctors often oversee the diagnostic process themselves.
In some cases, the doctor may refer the individual 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 special training in testing memory and other mental functions.
There is no single test that proves a person has Alzheimer’s. The workup is designed to evaluate overall health and identify any conditions that could affect how well the mind is working. When other conditions are ruled out, the doctor can then determine if it is Alzheimer’s or another dementia.
Experts estimate that a skilled physician can diagnose Alzheimer’s with more than 90 percent accuracy. Physicians can almost always determine that a person has dementia, but it may sometimes be difficult to determine the exact cause.
STEPS TO DIAGNOSIS INCLUDE:
Understanding the problem
- Be prepared for the doctor to ask:
- What kind of symptoms have occurred.
- When they began.
- How often they happen.
- If they have gotten worse.
Reviewing medical history
The doctor will interview the person being tested and others close to him or her to gather information about current and past mental and physical illnesses. It is helpful to bring a list of all the medications the person is taking.
The doctor will also obtain a history of key medical conditions affecting other family members, especially whether they may have or had Alzheimer’s disease or other dementias.
Evaluating mood and mental status
Mental status testing evaluates memory, the ability to solve simple problems and other thinking skills.
This testing gives an overall sense of whether a person:
- Is aware of 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 also 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
A physician will:
- Evaluate diet and nutrition.
- Check blood pressure, temperature and pulse.
- Listen to the heart and lungs.
- Perform other procedures to assess overall health.
The physician will collect blood and urine samples and may order other laboratory tests. Information from these tests can help identify disorders such as anemia, infection, diabetes, kidney or liver disease, certain vitamin deficiencies, thyroid abnormalities, and problems with the heart, blood vessels or lungs. All of these conditions may cause confused thinking, trouble focusing attention, memory problems or other symptoms similar to dementia.
A doctor will closely evaluate the person for problems that may signal brain disorders other than Alzheimer’s.
The physician will also test:
- Muscle tone and strength
- Eye movement
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 exam may also include a brain imaging study. The most common types are magnetic resonance imaging (MRI) or computed tomography (CT). MRIs and CTs can reveal tumors, evidence of small or large strokes, damage from severe head trauma or a buildup of fluid. Researchers are studying other imaging techniques so they can better diagnose and track the progress of Alzheimer’s.