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There
is no one test that will diagnose Alzheimer's disease.
It is diagnosed by a process of elimination. A doctor
will test for all other diseases known to produce
similar symptoms of dementia. Once these diseases
have been excluded, a diagnosis of probable dementia
of the Alzheimer's type is made. An early diagnosis
allows the individual time to plan for their future
and maximise the quality of their life.
Steps
to diagnosis:
The
first step to diagnosis is a thorough case history.
The doctor will ask you about specific cognitive (thinking
ability), memory and behavioural changes, their onset
and duration. You will also be asked if there is a
known family history of dementia.
Next
you may be given a Mini-Mental Status Examination.
This is a series of questions that is used to determine
the degree of memory impairment.
It
is important to exclude any of the illnesses that
can cause or simulate dementia. Medical history (including
medication review), a physical examination and diagnostic
tests are used to exclude systemic diseases, trauma,
psychiatric disorders, nutritional deficits and substance
abuse.
While
taking your medical history, the doctor will review
all the medications you are taking, including over
the counter medications such as cough syrup or pain
killers, and herbal or vitamin preparations. Combinations
of medicines can interact to cause symptoms of dementia.
Physical
examination and screening may include the following:
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A
complete blood count and electrolytes testing
are diagnostic tools used to exclude infections
and systemic diseases such as anemia.
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Thyroid
function tests will rule out hyper or hypothyroidism.
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Vitamin
B12 and Folate levels will identify any metabolic
abnormalities.
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These
three tests are measured through taking a blood sample,
and hurt no more than a pin prick. The doctor may
also order physical assessments such as chest x-rays,
electrocardiographs (ECG), electroencephalographs
(EEG), CAT scans or an MRI scan.
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An
electrocardiograph will detect cardiac abnormalities
and is used to identify cardiovascular disease.
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An
electroencephalograph records brain wave activity
and is used to diagnose seizure disorders, brainstem
disorders, focal lesions and impaired consciousness.
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A
Computerised Axial Tomography (CAT) scan and
Magnetic Resonance Imaging (MRI) can detect
changes in the structures of the brain such
as lesions, tumor masses, bone displacement
and accumulations of fluids.
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None
of these tests hurt. All however, require you to lie
still for a period of time. The noise of an MRI can
be disturbing for some people.
Neurological
assessment evaluates a person's nervous system, mental
status, sensory and neuromuscular functioning. Assessment
is used to exclude head trauma, seizures, strokes
or mental illness including depression. Again these
tests do not hurt. Most of these tests involve asking
the patient questions.
Once
all the tests have been completed, all the information
is put together to form a complete picture of the
person's health status. Time is probably the biggest
cost to the patient as all this testing may take some
weeks to complete.
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