How Do You Actually Get a Diagnosis of Alzheimer’s Disease?

pexels-photo-302083Mom has been forgetting more and more things. It doesn’t seem like just ordinary forgetfulness, like losing keys or forgetting that Thursday is bridge night at the neighbor’s house. She’s having trouble recalling words, birthdays, and even her famous lasagna recipe. Her personality seems to be changing, too. She’s more irritable and anxious, and she even snapped at her grandchildren for the first time. Family members are beginning to worry. Is it Alzheimer’s? How can you find out and get the right diagnosis for your loved one?

Is It Alzheimer’s?

The first step in receiving an Alzheimer’s diagnosis is to visit your doctor. In most cases, by the time someone makes a medical appointment to discuss the possibility of Alzheimer’s, symptoms are already strong enough to affect the individual’s quality of life.

Ongoing and worsening memory loss, as well as bouts of confusion and personality changes are all clear indicators of Alzheimer’s, but it’s important not to jump to conclusions. Other medical issues can mimic the symptoms of Alzheimer’s. That is why only a doctor can offer a true Alzheimer’s diagnosis.

Currently, there is no surefire way to confirm Alzheimer’s until after an individual has passed away and their brain can be examined for the telltale plaques and tangles. Instead, doctors can offer a highly confident diagnosis of Alzheimer’s by eliminating all other potential causes of an individual’s symptoms.

Diagnosing Alzheimer’s often requires multiple medical appointments and a variety of physical and neurological tests. Here’s what to expect when your loved one visits the doctor.

A Physical Exam

Your doctor will most likely start off with a simple physical exam to rule out any obvious physical issues that could be causing or exacerbating symptoms. During the physical exam, the doctor may assess your loved one’s:

  • Weight
  • Blood pressure
  • Temperature
  • Coordination
  • Balance
  • Muscle tone
  • Reflexes
  • Hearing
  • Eyesight

The doctor may also take a medical history and ask the patient as well as family members about the symptoms they’ve observed.

Lab Tests

The next step is performing lab tests to rule out other conditions. Common tests include:

  • Blood test to check for thyroid issues and vitamin deficiencies
  • Urine test to check kidney function and screen for kidney infections

In rare cases, a doctor may request a cerebrospinal fluid analysis, which requires a spinal tap to collect cerebrospinal fluid in order to perform a protein analysis

Cognitive Testing

While the doctor works to eliminate the possibility of other health issues, he or she will also perform cognitive tests to determine if your loved one’s memory and other cognitive skills really are diminished compared to a normal baseline for their age.

The doctor will typically administer a short test that requires your loved one to perform simple cognitive tasks, like remembering a list of words, solving a simple math problem, or correctly identifying pictures of objects.

It is also common for doctors to perform a test for depression, since depression and also affect memory and mood.

Neurological Testing

In some instances, if the doctor believes a different condition may be causing your loved one’s symptoms, he or she may order a range of neurological tests, including:

  • Computerized Tomography (CT) Scan – This test produces cross-sections of the brain and is used to look for brain tumors, strokes, and brain injury
  • Magnetic Resonance Imaging (MRI) Scan – An MRI scan will allow the doctor to see detailed images of the brain, which can be used to rule out tumors and to check to see if certain regions of the brain associated with Alzheimer’s have shrunk.
  • Positron Emission Tomography (PET) Scan – PET scans are a newer type of test that is only available in research settings and clinical trials. Before a PET scan, your loved one will receive an injection of a low-level radioactive tracer. Once in the scanner, the tracer will light up, allowing doctors and researchers to see activity in the brain. This can also be used to identify tangles and plaques that are the hallmarks of Alzheimer’s

Future Tests

Researchers and doctors around the world are hard at work to develop a test that can definitively diagnose Alzheimer’s as well as testing protocols that can catch the condition early, before major damage to the brain has occurred.

In the future, we will likely see higher resolution and more sensitive scanning tests, better cognitive tests, and lab tests that can better measure the key biomarkers of Alzheimer’s, possibly before an individual’s symptoms even begin to show!

For now, however, doctors have gotten pretty good at diagnosing Alzheimer’s with the tests and equipment we currently have available. If you suspect that a loved one has Alzheimer’s, it’s important to schedule an appointment with your doctor sooner rather than later. Getting a diagnosis may be painful, but it is rarely surprising, and it can help encourage your family and your loved one to begin planning proactively for the future.

An Alzheimer’s diagnosis is scary, confusing, frustrating, and heartbreaking, but it is also a challenge you can meet with dignity and perseverance. Oftentimes, it can be a great help to receive support and insight from other families that are further along on their Alzheimer’s and dementia journey. If you live in Poway or San Diego County, we invite you to our free monthly Caregiver’s Support Group.

We’d love to meet you and hear your story.


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