08 February 2009

Diagnosing Alzheimers / Dementia

Most people contact their own family doctor first. He or she will do some simple memory tests. If still concerned, the doctor might refer the patient to a neurologist, psychiatrist or psychologist for further evaluation. The family doctor will coordinated everyone's contribution to the diagnosis and treatment.

If the patient would like to find a new doctor, someone with more experience with Alzheimers than the typical family doctor, then they can contact the Alzheimer’s Association to get some names and contact information.

There is no such thing as a single "Alzheimers Memory Test" that makes the diagnosis all by itself. Alzheimers is more complicated than that. The doctors are going to look at the patient's mind, body and soul to find any conditions that could affect how the brain works. There are other things besides Alzheimers that affect our memory and thinking such as anemia, malnutrition or certain vitamin deficiencies, excess use of alcohol, medication side effects, certain infections, diabetes, kidney or liver disease, thyroid problems, and issues with the heart, lungs or blood vessels.

Here are some questions your doctor might ask at the initial appointment:
  • What kind of symptoms have you noticed?
  • When did they begin?
  • How often do they happen?
  • Have they gotten worse?
Important Note - The Alzheimer's Association says that home screening tests should not be used instead of seeing a doctor. Don't let someone who is trying to pray on your insecurities and take your money, tell you whether or not you have a mental condition! You need to see a doctor, one-on-one, who knows what he or she is doing!

Besides asking basic questions like the ones above, the doctor will also interview the patient and their spouse/family members about current and past illnessess. The doctor will ask about certain medical conditions, including Alzheimers, that might exist elsewhere in the family tree.

The doctor will do what is called "Mental Status Testing" which gives the doctor an idea of whether a person:

  • Is aware of having symptoms or feels nothing is wrong at all
  • Knows today's date, time and location
  • Can do simple mental exercises on the "Clock Drawing Test", "Mini-Mental State Exam" or "Mini Cog" test
  • Do a neurological exam which covers reflexes, coordination and balance, muscle tone and strength, eye movement, speech and sensation

A neurological exam is another part of the physical. Structural Brain Imaging such as MRI's and CT's show the shape, position and volume of brain tissue. Functional Brain Imaging shows the doctor how well brain cells in various regions are working by showing how actively the cells are using sugar and oxygen. Functional Techniques to look at the brain include Positron Emission Tomography (PET) and functional MRI's (fMRI). Many of these images are used to detect and rule out tumors, strokes, damage from severe head trauma or a buildup of fluid.

If I have any advice to give, it would be to see a doctor early. If you catch Alzheimer's early, you can fight back and delay or lessen it's severity. Do all the tests, just in case the cause of the patient's problem is something else, or co-existing with Alzheimer's.

Click on the following links for detailed information on:

Mini Mental State Exam

Mini Cog Test

Clock Drawing Test


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