How To Diagnose Alzheimers Vs Dementia
Alzheimers is a progressive and fatal brain disorder. Dementia is not a specific disease, but an umbrella term that defines a syndrome and used to refer to a specific group of symptoms related to a decline in mental ability. Alzheimers is one of the most common causes of dementia. Both Alzheimers and dementia are diagnosed using a variety of different assessments and tests, including a physical exam, lab tests, cognitive and neuropsychological tests, and an analysis of changes in behavior.
What Newer Medications Are Under Study
All currently approved medications target Alzheimers disease after it develops. Scientists are currently researching ways to stop or slow the progress of Alzheimers disease before it starts.
Some of the drugs in late-stage investigation are called monoclonal antibodies. These drugs target the amyloid protein that builds up in brain cells. They work by attaching to the amyloid proteins as they float in the brain and remove them, before they form into the plaques and tangles that interfere with the brains ability to properly function.
These drugs are still in clinical trials and are several years away from Food and Drug Administration approval in the United States. Early results have been mixed, with some trials showing no improvement in brain function others showing a slight improvement . Despite the mixed results, researchers are excited about this new potential method to modify the disease process.
Simple Blood Test May Be Able To Diagnose Alzheimers Disease
A simple blood test may soon be able to diagnose patients with two common forms of dementia Alzheimers disease and frontotemporal dementia and tell the two apart.
Researchers at UC San Francisco analyzed the blood test in more than 300 patients and say they hope to see such a test available in doctors offices within five years.
This test could eventually be deployed in a primary care setting for people with memory concerns to identify who should be referred to specialized centers to participate in clinical trials or to be treated with new Alzheimers therapies, once they are approved, said Adam Boxer, MD, PhD, neurologist at the UCSF Memory and Aging Center and senior author of the study published in Nature Medicine. Boxer also is affiliated with the UCSF Weill Institute for Neurosciences.
No blood test currently exists for either condition. Alzheimers diagnoses can only be confirmed by a PET scan of the brain, which can be costly, or an invasive lumbar puncture to test cerebrospinal fluid.
If approved, the new blood test could ease screening and help increase the number of patients eligible for clinical trials, which are essential to the search for drugs to stop or slow dementia. Patients who know whether they have Alzheimers or FTD are also better able to manage their symptoms, which may differ between the two conditions.
Adam Boxer, MD, PhD
Don’t Miss: Did Margaret Thatcher Have Dementia
Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job. Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction. When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
Medical History And Mental Status Examination
Clinical assessment of a patients history and performing a mental status examination are necessary steps in the evaluation of cognitive disorders. In identifying the presence of AD, the presence of a typical slow and insidious progression of symptoms is sought. Other factors capable of producing cognitive impairment are identified, including medical disorders, substances or medications that can cause cognitive impairment, or psychiatric conditions associated with cognitive changes. The characteristic clinical syndrome of AD includes a prominent disturbance of what is known as episodic memory .
Memory of recent events is particularly impaired, and evidence that reminders are of limited benefit is consistent with the memory storage problem typically found in AD. Language and visuospatial problems may also be reported or identified. In less common variants of AD, the disturbance of language or visual functions may be more prominent than memory difficulties in the diseases early stage.
What Are The Symptoms Of Alzheimers Disease
Symptoms of Alzheimers disease vary from person to person and worsen over time. Symptoms of the disease include:
- Memory loss. This is usually one of the first symptoms of Alzheimers disease.
- Putting objects in odd places
- Confusion about events, time and place
- Repeating questions
For more information on the stage of disease, click here.
Referral To A Specialist
If a GP is unsure about whether you have Alzheimer’s disease, they may refer you to a specialist, such as:
- a psychiatrist
- an elderly care physician
- a neurologist
The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.
There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff at the memory clinic will listen to the concerns of both you and your family about your memory or thinking.
They’ll assess your memory and other areas of mental ability and, if necessary, arrange more tests to rule out other conditions.
Recommended Reading: Does Prevagen Work For Dementia
How Accurate And Reliable Are The Results
Like any test, SAGE is not perfect. Scharre points out that individuals have a wide variety of cognitive talents and this needs to be taken into account. There will be individuals who score well but have a decline from their previous abilities. Repeat testing over time will find those that are progressing, he explains.
Some individuals will not score as well, but that may represent their baseline talents, and their score would not suggest any specific brain condition,” he adds. This is why its important to have the test interpreted in light of ones medical history by a healthcare provider.
Its important to note that other factors could be affecting your memory and thinking on any given day.
Perhaps you dont have a memory impairment but are quite depressed, ill, or sleep deprived. explains Jessica Z. K. Caldwell, PhD, director of neuropsychology training and staff neuropsychologist at Cleveland Clinics Ruvo Center for Brain Health in Las Vegas, Nevada. If you have concerns about your memory but are also experiencing these symptoms, Dr. Caldwell suggests you see your doctor.
Future Of Alzheimers Blood Tests
When blood tests become mainstream, they will significantly impact the way doctors diagnose and even treat the condition.
Beyond the Preclivity AD and Simoa described above, there are multiple other types of blood tests in development some are looking at protective fats in the blood. Research shows that an increase in fatty amide levels indicates more beta amyloid in the brain. Beta amyloid plaques have been found in the brains of people with Alzheimers.
Other blood tests will measure proteins such as tau proteins and the neurofilament light chain protein. Researchers have found that neuron death, characteristic in people with Alzheimers, may be detected by the corresponding increase of these proteins in the blood.
It is also possible that the probable link between insulin resistance, diabetes and Alzheimers means blood tests could show the disease in someone well before symptoms occur. Another protein called IRS-1 is commonly associated with diabetes but has also been linked to Alzheimers. Studies have shown that someone with Alzheimers has more IRS-1 than even someone with diabetes.
You May Like: Andrea Mitchell Drunk
What Kind Of Doctor Tests For Dementia
A primary care doctor can perform a physical exam and find out more about your symptoms to determine what may be the cause. They will likely refer you to one or several specialists that can perform specific tests to diagnose dementia. Specialists may include neurologists, who specialize in the brain and nervous system psychiatrists or psychologists, who specialize in mental health, mental functions, and memory or geriatricians, who specialize in healthcare for older adults.
Genetic Testing For Alzheimer’s Disease
A blood test can identify which APOE alleles a person has, but results cannot predict who will or will not develop Alzheimer’s disease. Currently, APOE testing is used primarily in research settings to identify study participants who may have an increased risk of developing Alzheimer’s. This knowledge helps scientists look for early brain changes in participants and compare the effectiveness of possible treatments for people with different APOE profiles.
Genetic testing is also used by physicians to help diagnose early-onset Alzheimers disease and to test people with a strong family history of Alzheimers or a related brain disease.
Genetic testing for APOE or other genetic variants cannot determine an individuals likelihood of developing Alzheimers diseasejust which risk factor genes a person has. It is unlikely that genetic testing will ever be able to predict the disease with 100 percent accuracy, researchers believe, because too many other factors may influence its development and progression.
Some people learn their APOE status through consumer genetic testing or think about getting this kind of test. They may wish to consult a doctor or genetic counselor to better understand this type of test and their test results. General information about genetic testing can be found at:
Recommended Reading: What Is The Difference Between Dementia And Senility
What Is Cognitive Testing For Alzheimer’s
These include the Mini Mental State Examination , the most used for clinical purposes, and the Alzheimer’s Disease Assessment Scale cognitive subscale , the most used for measuring the effect of treatments.
Similarly, can you test yourself for Alzheimer’s? The Self-Administered Gerocognitive Examination is an online test that promises to detect the early stages of Alzheimer’s disease or dementia. Developed by researchers at Ohio State University, the test is designed to be done at home and then taken to a physician for a more formal evaluation.
Thereof, what is a cognitive function test?
The Cognitive Function Test is a free online tool that aims to measure this gap to give people the opportunity to know if they are on the green line with normal brain aging or on the red line, in which the brain’s function is declining in a way that suggests future Alzheimer’s disease.
What is a good score on a memory test?
The maximum MMSE score is 30 points. A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer’s declines about two to four points each year.
Looking More Closely At The Brain
Leading researchers say there are good reasons to seek early detection: People have time to plan, to try drug therapy, and to live their last good years fully. Yet such knowledge comes at a high price: With no cure yet in sight, people like Les Dennis must live with the awareness that they are gradually slipping into dementia.
“We’re becoming aware that Alzheimer’s doesn’t start overnight and could be preceded by years of a vulnerable state,” says Sandra Weintraub, PhD, director of neuropsychology at Northwestern University’s Cognitive Neurology and Alzheimer’s Disease Center. Only 3% of Americans are diagnosed with Alzheimer’s between the ages of 65 and 74. But by age 85, a stunning 47% have the disease, according to the National Institute on Aging. By detecting Alzheimer’s at the earliest point during those critical years, she says people like Les Dennis benefit from a “window of warning” — time they can use to plan the care they’ll need, to settle financial matters, or simply do the things they love the most.
Many of the tests are not new. Rather, in recent years researchers have grown more skilled at using them. One of the most reliable is the California Verbal Learning Test, which assesses skills such as verbal memory and problem solving.
These cognitive tests are about 90% accurate in identifying people who have very mild dementia,” says David Salmon, PhD, a professor in residence in the department of neurosciences at the University of California, San Diego.
You May Like: Do People With Dementia Dream
Potential Breakthrough For Prevention And Treatment
Researchers hope that their findings lead to breakthroughs in treatment methods. Senior study author, Dr. Ed Goetzl, says:
My vision of the future is you have your breakfast cereal, and on one side you have a statin for cardiovascular disease and on the other side you have three pills to prevent dementia.
He went on to state that, This study shows that insulin resistance is a major central nervous system metabolic abnormality in Alzheimers disease that contributes to neural cell damage. As insulin resistance is a known condition in type 2 diabetes and is treatable with several classes of existing drugs, these treatments may be useful as part of a multi-agent program for Alzheimers.
The blood test is still in the early stages of development and will require a larger and longer study before it can be used to detect Alzheimers. The lead author of the study and neuroscientist at the National Institute on Aging, Dimitrios Kapagiannis, says: We will need replication and validation, but Im very optimistic this work will hold.
Do you think the newest blood test is a viable way to prevent Alzheimers disease? Please share your thoughts with us in the comments below.
Why Would Anyone Want An Early Alzheimers Diagnosis
The SAGE test is useful because it helps you understand if your concerns are something to be worried about.
If the results seem to indicate that there could be a problem, you might think theres no point in talking with the doctor because theres no cure for dementia.
The most important is that a treatable condition could be the cause of cognitive impairment. Finding out sooner means getting treatment ASAP to eliminate the cognitive symptoms.
If the cognitive impairment is caused by Alzheimers or dementia, a major benefit is that starting treatment early is far more effective in managing symptoms and delaying progression of the disease.
Recommended Reading: Does Andrea Mitchell Have Dementia
Some Questions You May Wish To Ask You Doctor Regarding Tests Used In Diagnosing Dementia
- What tests will be conducted?
- Who will be performing the tests and how long will it take?
- Should I prepare for the tests in any way?
- Will any of the tests involve pain or discomfort?
- Will there be any cost involved?
- What follow-up will be necessary and who will follow up?
- How will I be informed of the test results and the diagnosis?
What Conditions Can Be Mistaken For Dementia
The term dementia refers to a specific group of symptoms related to a decline in mental ability. Often, people who experience subtle short-term memory changes, are easily confused, or exhibit different behaviors or personality traits are mistakenly thought to have dementia. These symptoms could be the result of a variety of other conditions or disorders, including other neurocognitive disorders such as Parkinsons disease, brain growths or tumors, mild cognitive impairment , and mood disorders, like depression.
Don’t Miss: Meredith Grey Alzheimer\’s Trial
What Is The Clock Test For Dementia
The clock test is a non-verbal screening tool that may be used as part of the assessment for dementia, Alzheimers, and other neurological problems. The clock test screens for cognitive impairment. The individual being screened is asked to draw a clock with the hour and minute hands pointing to a specific time. Research has shown that six potential errors in the clock testthe wrong time, no hands, missing numbers, number substitutions, repetition, and refusalcould be indicative of dementia.
New Blood Marker Renews Hope For Blood Test To Detect Alzheimers
Another study from the University of Otago has also revealed another blood marker that could help diagnose Alzheimers through a simple blood test. Researchers found that participants with a small number of molecules found in the blood and brain called microRNAs can correctly detect Alzheimers with 86% accuracy.
This study involved participants that had been diagnosed with the disease, as well as neurologically healthy individuals. Researchers found that three microRNAs were different between the two groups and detecting these microRNAs would be possible through a simple blood test. Dr. Joanna Williams, who led the screening of microRNA in blood samples of participants, says, Although there are other known markers of early Alzheimers disease, such as an accumulation of the protein beta-amyloid in the brain, testing for these involves expensive or invasive procedures that cant be used in routine clinical practice.
Dr. Williams went on to state, We know that the levels of these microRNAs differ in people who have Alzheimers and people who dont. So if a general practitioner took a blood sample from a patient who was beginning to show symptoms of memory loss, what wed do is analyze that blood and see how that patients pattern of microRNA compares against established patterns.