Diagnosing Alzheimer’s disease through symptoms

Image Source: Alzheimer’s Association

Every 4 seconds a person is diagnosed with Alzheimer’s disease. It is the most common cause of Dementia affecting over 40 million people worldwide and still, there is no particular care/treatment available for it. It is associated with the slow progression of memory loss due to the impaired connection between the neurons over several years, especially in the geriatric group. Researchers have found that it takes a decade or more of brain-related issues before most people show signs and symptoms of Alzheimer’s research. Scientists & researchers are working to find out some new biomarkers which will be accurate, measurable and reliable to detect AD at a very early stage.

Diagnosis at an early stage:

It is very important for an AD patient to get an accurate diagnosis as early as possible for the appropriate treatment. Although there is no cure for AD doctors do advise certain drugs and therapies that can slow down cognitive decline. Some of the early signs and symptoms of the AD are very common in elderly population but a skilled Neurologist, Psychologist, Psychiatrist or a Geriatrician can diagnose AD based on following warning signs and symptoms:

    • Episodic memory Loss
    • Cognitive changes (e.g. language, thinking or judgment)
    • Mood changes (anxious, apathetic, depression)
  • Assistance needed with the complex as well as daily tasks like:
    1. Keeping track of finance
    2. Paying bills
    3. Keeping track of time and place
    4. Preparing meals
    5. Scheduling an appointment
    6. Driving
    7. Withdrawal from social activities and work (increased absenteeism)
    8. Difficulty in decision making and problem-solving
    9. Difficulty in remembering names and frequently used words.
    10. Trouble in understanding visual images

Although the signs and symptoms, highlighted above, are hard to recognize and diagnose at an early stage, medical attention and clinical assessment for diagnosis is a must as the patient progresses in the disease.

Primary Diagnosis of Alzheimer’s disease includes:

  • Complete History: Includes family and medical history about the present and past illness  
  • Physical examination: Checking vital signs (Blood Pressure, pulse, temperature, and heart rate) and asking questions about alcohol consumptions and the diet.
  • Neurological examination: Includes testing of speech, reflexes, muscle tone, eye movement, sensation, strength, coordination and any evidence of stroke.
  • Cognitive changes: Cognitive tests are administered to characterize and quantify memory loss, and explore other changes in cognitive function
  • Behavioral changes: Includes interviews with the patient’s family members and friends, as they are the best people to tell about any patient behavior changes over time.
  • Blood tests: To exclude infections, vitamin deficiencies and other abnormalities that could cause memory loss.
  • Brain Imaging techniques: These are very useful, for example, shrinkage of memory centers can be seen on an MRI which is a telltale sign for the AD. Other important Imaging techniques include CT Scans, PET Scans or spinal tap.
  • Neuropsychological Test: Advised if the changes seen are very subtle. It can include extensive tests to evaluate thinking and memory skills.

Confirmed Diagnosis of Alzheimer’s disease

In case of a cognitive decline in patients, the confirmed diagnosis of Alzheimer’s disease can be made based on the exclusion of other indications and infections, based on certain medical tests conducted which are mentioned as below::

    • Blood test report: No sign of infection or any other abnormality. Tests are normal.
    • No significant mood disorder such as depression
    • Brain imaging shows clear-cut memory loss but no other significant cause.
  • Evidence of decreased capacity to manage day-to-day activities and functions.

Sometimes, patient experiences significant memory loss without any deceased ability to perform daily activities. In such cases, it is difficult to make a diagnosis of Alzheimer’s disease with confidence. Physicians may refer this as Mild cognitive impairment (MCI). The patients with MCI are also at a higher risk of developing AD but not all MCI patients, progress to the AD.

Arriving at the correct diagnosis can take time and patience. But, keeping a proactive approach is very useful such as visiting a doctor, the moment the patient notices any symptoms, asking the doctor the best way to contribute on an ongoing basis, solving puzzles, etc. Patients must keep doing some brain quiz or brain exercises to make sure that their brain is working at an optimum level.

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