How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
Frontotemporal Dementia With Parkinsonism
One form of familial FTD, also known as frontotemporal dementia with Parkinsonism-17 , is caused by genetic changes in the gene for tau protein, located on chromosome 17. No other risk factors for this condition are known.
FTDP-17 is rare and accounts for only three per cent of all cases of dementia. Symptoms progressively get worse over time and usually appear between the ages of 40 and 60. The condition affects both thinking and behavioural skills and movements such as rigidity, lack of facial expression and problems with balance .
It can be distressing to be told that you have a genetic disorder or are at risk of having one. Genetic counselling provides the person and their family with information about a genetic disorder and its likely impact on their lives. This can assist a person with FTDP-17 to make informed medical and personal decisions about how to manage their condition and the challenges it presents to their health and wellbeing. Prenatal genetic counselling is also available for parents to help them decide about a pregnancy that may be at risk of FTDP-17.
Understanding Different Types Of Dementia
As we age, its normal to lose some neurons in the brain. People living with dementia, however, experience far greater loss. Many neurons stop working, lose connections with other brain cells, and eventually die. At first, symptoms can be mild, but they get worse over time.
Read on to learn more about four different types of dementia.
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Are There Different Types Of Alzheimer’s Disease
Alzheimers drug trials have been fraught with failure. A study last year that made headlines reported more than 99% of all Alzheimers drugs have flopped in the past decade, and only one new medicine to mediate symptoms of the disease has been approved since 2004.
The problem is, scientists still dont know what exactly causes Alzheimers disease, though a protein called amyloid beta is most often implicated. Scientists think that amyloid-beta proteins build up and form deposits, known as amyloid plaque, which are to blame for the characteristic cognitive declines of the disease. Most Alzheimers drugs tested in clinical trials have used amyloid beta as the pharmacological target. The study found that out of 221 trials of disease-modifying agents registered from 2002 to 2012, more than 65% or 145 trials involved experimental drugs that targeted amyloid beta.
The other target drug developers have been interested in is a protein called tau, which has been found in deposits in the brains of people with a variety of neurological diseases. But tau-related therapies have also failed, leading some researchers to speculate that the existence of these proteins may not be the major culprit behind this devastating condition after all or, at the very least, other factors are at play.
Treatment For These Four Types Of Dementia
There is currently no cure for these types of dementia, but some treatments are available. Speak with your doctor to find out what might work best for you.
Living with dementia can be challenging, but there are ways to manage it. Learn more about the types of dementia and other conditions that can cause dementia.
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How Is Dementia Diagnosed
Confirming the diagnosis of dementia can be difficult due to the many diseases and conditions that cause it as well as because its symptoms are common to many other illnesses. However, doctors are able to make the diagnosis based on the results of personal medical history, review of current symptoms, neurological and cognitive tests, laboratory tests, imaging tests and by interacting with the patient.
Current general symptoms that would indicate dementia are, by definition, a decline in such mental functions as memory, thinking, reasoning, personality, mood or behavior that are severe enough to interfere with the ability to accomplish everyday tasks. Patients undergo mental function testing to identify problems in these areas. Interviews with family members and/or close friends who may have noticed changes in these areas are helpful as well.
Laboratory tests rule out other diseases and conditions as the cause of dementia, such as thyroid problems and vitamin B12 deficiency. Similarly, brain scans can look for signs of a stroke or tumor that may be the source of the dementia. A PET scan can determine if amyloid proteins are present in the brain, a marker for Alzheimers disease.
Oftentimes, neurologists and geriatricians assist in making the diagnosis.
Dementia: What Are The Main Types
While ageing, the brain encounters significant modifications. For example, from the age of 60, it slowly starts to shrink. Heart diseases and head traumas can also have an important effect on the brain, sometimes causing dementia. A persons family history also influences the occurrence of this kind of syndrome.
Dementia is a significant sign of progressive neurodegeneration. This causes the death of some brain cells as well as tissue loss. The most frequently affected areas are the memory, the thinking, the behaviour and the ability to do some tasks for the sick person.
Continue below to learn what are the five different types of dementia.
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How Does Alzheimer’s Disease Affect The Brain
Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.
The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.
Symptoms Of Alzheimers Disease
- Problems recognizing friends and family
- Impulsive behavior
- Difficulty resisting the impulse to use or touch objects
- Compulsive eating
- Trouble following instructions or learning new information
- Hallucination or delusions
- Poor judgment
Typical age of diagnosis for Alzheimers disease: Mid-60s and above, with some cases in mid-30s to 60s
Typical age of diagnosis of frontotemporal dementia: Between 45 and 64
Typical age of diagnosis of Lewy body dementia: 50 or older
Typical age of diagnosis of vascular dementia: Over 65
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Health Environmental And Lifestyle Factors That May Contribute To Alzheimer’s Disease
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer’s disease. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimer’s.
A nutritious diet, physical activity, social engagement, sleep, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimer’s disease. Clinical trials are testing some of these possibilities.
Early-life factors may also play a role. For example, studies have linked higher levels of education with a decreased risk of dementia. There are also differences in dementia risk among racial groups and sexesall of which are being studied to better understand the causes of Alzheimers disease and to develop effective treatments and preventions for all people.
What Is Alzheimers Disease
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Alzheimers disease is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. People with Alzheimers also experience changes in behavior and personality.
More than 6 million Americans, many of them age 65 and older, are estimated to have Alzheimers disease. Thats more individuals living with Alzheimers disease than the population of a large American city. Many more people experience Alzheimer’s in their lives as family members and friends of those with the disease.
The symptoms of Alzheimers disease changes in thinking, remembering, reasoning, and behavior are known as dementia. Thats why Alzheimers is sometimes referred to as dementia. Other diseases and conditions can also cause dementia, with Alzheimers being the most common cause of dementia in older adults.
Alzheimers disease is not a normal part of aging. Its the result of complex changes in the brain that start years before symptoms appear and lead to the loss of brain cells and their connections.
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Help From The Ontario Government
Caring for someone with dementia can be difficult, but help is available. Each province in Canada offers different resources and programs for dementia patients and caregivers. Were going to look at the options available in Ontario, however if you live in a different province, similar options will likely be provided.
What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
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Cortical And Subcortical Dementia
Medical professionals sometimes categorise dementia into cortical and subcortical dementia.
Cortical dementia is typically associated with the brains grey matter, which is the characteristic outer structures of the brain. These outer structures have an important role in processing information and in functions such as language and memory. Types of cortical dementia include Alzheimers, frontotemporal dementia, Binswangers disease and Creutzfeldt-Jakob disease.
Subcortical dementia initially affects structures below the cortex in the innermost parts of the brain known as white matter. These inner structures responsible for controlling the speed of thought processes and emotions. Types of subcortical dementia include Huntingtons disease, Parkinsons dementia, and AIDS dementia complex.
The progression of dementia is not necessarily affected by category or type, but a variety of factors including lifestyle, health and genetics.
Signs And Symptoms Of Alzheimer’s Disease
Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers. Some people with memory problems have a condition called mild cognitive impairment . With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimers, but not all of them do so. Some may even revert to normal cognition.
The first symptoms of Alzheimers vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimers. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimers in a health care providers office.
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Other Causes Of Dementia
Just about any condition that causes damage to the brain or nerve cells can cause dementia. For example, people with Parkinsons disease will often exhibit dementia in the later stages of their illness. Huntingtons disease, Creutzfeldt-Jacob disease and alcoholism can all lead to irreversible cognitive impairment.
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What Are The Stages Of Dementia
The stages of dementia vary from person to person and the type of dementia. Keeping the four common types of dementia in mind, these seven stages are the usual progression that is experienced:
- No symptoms yet, but tests might reveal a problem
- Very mild changes in behavior, but independence remains
- Mild decline is noticeable, including changes in thinking, forgetting events, and repeating statements
- Moderate decline, meaning trouble remembering recent events and handling money
- A moderate to severe decline where they forget names, are unsure what time of day it is, and need some assistance with basic daily tasks
- Their decline is severe they are forgetting their spouses name, their personality is changing, and they need help eating and going to the bathroom
- Very severe decline, where they are unable to walk, can no longer speak their thoughts, and spend most time in bed
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What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, the appropriate drugs used to treat those specific conditions are prescribed.
How Alzheimer’s Disease Is Treated
There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
Read more about treating Alzheimer’s disease.
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What Are The Stages Of Alzheimers
Alzheimers disease slowly gets worse over time. People with this disease progress at different rates and in several stages. Symptoms may get worse and then improve, but until an effective treatment for the disease itself is found, the persons ability will continue to decline over the course of the disease.
Early-stage Alzheimers is when a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimers disease is often diagnosed at this stage.
During middle-stage Alzheimers, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends.
In late-stage Alzheimers, a person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down.
How long a person can live with Alzheimers disease varies. A person may live as few as three or four years if he or she is older than 80 when diagnosed, to as long as 10 or more years if the person is younger. Older adults with Alzheimers disease need to know their end-of-life care options and express their wishes to caregivers as early as possible after a diagnosis, before their thinking and speaking abilities fail.
How Is Alzheimers Diagnosed And Treated
Doctors may ask questions about health, conduct cognitive tests, and carry out standard medical tests to determine whether to diagnose a person with Alzheimers disease. If a doctor thinks a person may have Alzheimers, they may refer the person to a specialist, such as a neurologist, for further assessment. Specialists may conduct additional tests, such as brain scans or lab tests of spinal fluid, to help make a diagnosis. These tests measure signs of the disease, such as changes in brain size or levels of certain proteins.
There is currently no cure for Alzheimers, though there are several medicines approved by the U.S. Food and Drug Administration that can help manage some symptoms of the disease along with coping strategies to manage behavioral symptoms. In 2021, FDA provided accelerated approval for a new medication, aducanumab, that targets the protein beta-amyloid, which accumulates abnormally in the brains of people with Alzheimers. The new medication helps to reduce amyloid deposits, but has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.
Most medicines work best for people in the early or middle stages of Alzheimers. Researchers are exploring other drug therapies and nondrug interventions to delay or prevent the disease as well as treat its symptoms.
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