A number of tests can be performed when it is suspected that a person has Alzheimer's disease. A correct diagnosis can help guide therapy according to a person's needs. A full diagnosis usually starts with the patient's primary physician and is followed by referrals to specialists who can help with the confirmation.
Patient History
To establish the history of complaints the patient and family will be asked to detail types and times of problems associated with the symptoms of Alzheimer's disease. These include short-term memory difficulties, behavioral changes, forgetting how to perform basic tasks, disorientation and increased apathy. Questions will also be asked with regard to the patient's medical history.
This questioning is important as there are other medical reasons for symptoms associated with Alzheimer's disease, such as memory problems linked to alcohol use or head injury, a bladder infection being the cause of confusion or behavioral changes being due to depression or changes in a personal situation.
Physical Examination
The physical evaluation should include looking for signs that a person has had any other sort of brain injury. For instance if a person has had a stroke they may have problems in other parts of their body such as over reactive reflexes, movement impairments and speech difficulties.
Cognitive Tests
Cognitive tests evaluate factors such as memory, planning, attention and spatial awareness. They can help with the initial evaluation and diagnosis and with tracking disease progression and treatment response. These tests may be carried out by a primary physician or a specialist such as a neurologist, psychologist or psychiatrist.
One of the most widely used tests is the Mini-Mental State Examination, or MMSE. This includes tasks such as object naming and remembering, counting backwards in multiples of seven, reading and following simple instructions and answering questions on time and place. The test is scored from one to 30 with scores of more than 23 generally being considered normal, depending on age and education.
The "clock-drawing test" involves drawing a clock consisting of a round face with numbers and the hands at a particular time. This test can help distinguish between dementia causes. People with mild to moderate Alzheimer's should be able to draw most of the clock's elements but may leave out some numbers or only put in one hand. People with a disorder called frontotemporal dementia are less able to draw a recognizable clock and may, for instance, put the numbers in the wrong position or not draw any hands.
Blood Tests
There are a number of tests with machines that can show different structural features of a person's brain. Two such are computed axial tomography, or CAT, and magnetic resonance imaging, or MRI. In those with Alzheimer's disease certain parts of the brain can shrink, while the fluid-filled spaces, called ventricles, enlarge. Neuroimaging can also see if a person has any sort of tumor, has had a stroke, or has swelling due to increased amounts of fluid in the brain.
Neuroimaging
There are a number of tests with machines that can show different structural features of a person's brain. Two such are computed axial tomography, or CAT, and magnetic resonance imaging, or MRI. In those with Alzheimer's disease certain parts of the brain can shrink, while the fluid-filled spaces, called ventricles, enlarge. Neuroimaging can also determine if a person has any sort of tumor, has had a stroke, or has swelling due to increased amounts of fluid in the brain.
References
- "American Family Physician;" Early Diagnosis of Dementia; Karen Santacruz and Daniel Swagerty; February 2001
- "Canadian Medical Association Journal;" Diagnosis and Treatment of Dementia: 2. Diagnosis; Howard Feldman et al; March 2008
- "Alzheimer's Association;' Diagnosing Alzheimer's
