Key Points About Early
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Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.
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It affects memory, thinking, and behavior.
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Although there is no known cure, early diagnosis and treatment can lead to better quality of life.
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Stay healthy with a good diet and regular exercise.
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Avoid alcohol and other substances that may affect memory, thinking, and behavior.
What Kind Of Cognitive Tools Were Used To Develop Brainguide
The BrainGuide memory questionnaires are adapted from commonly applied and validated tools in the healthcare community. The self-assessment is based on the MIS/MIS-T and the caregiver assessment is based on the AD8 . These assessments were adapted for use with a voice or web bot. They are not intended to diagnose or make treatment recommendations.
When Is Genetic Testing For Dementia Appropriate
In some cases, it may seem likely that a persons dementia is caused by a single-gene change for example, if the person has a very strong family history of dementia. In these cases, it may be appropriate to offer genetic testing to the person and to their family.
However in most families dementia will not be caused by a single-gene change. In these cases, genetic testing will not be appropriate. This is because testing for risk variants does not provide any certainty about the persons chances of developing dementia.
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The Truth About Dementia Tests
Certain tests for dementia don’t offer much diagnostic value in general, including genetic tests for Alzheimer’s. The only gene tests that can accurately determine whether you’ll get Alzheimer’s disease are for the autosomal dominant form, also known as familial early-onset Alzheimer’s disease. It is very rare, accounting for less than 5% of total cases, and it typically starts before middle age.
A blood test for the Alzheimer’s risk gene, APO-e4, also exists. However, the use of APO-e4 as a screening measure is controversial because it can’t determine for sure whether you will develop the disease.
Also of questionable merit are the do-it-yourself, at-home tests for dementia that are marketed directly to consumers. The Alzheimer’s Association doesn’t recommend these tests, because they don’t provide an adequate assessment of your risks. Distinguishing between normal, age-related memory changes and early signs of a more worrisome condition can be difficult. If you’re going to be evaluated for dementia, you want a neuropsychologist, neurologist, geriatrician, or geriatric psychiatrist to do the testing and help you understand the results.
Clinical Tests For Alzheimers & Dementia
Montreal Cognitive Assessment
The Montreal Cognitive Assessment is also 30 questions, like the MMSE above, and takes about 10 minutes. The MoCA includes the Clock Drawing Test and also has questions and small tasks to assess someones understanding of time and place, as well as their short-term memory and ability to concentrate. MoCA is similar to the MMSE but about 30 years newer. Studies have shown MoCA is more reliable for identifying dementia, and better at identifying early-stage dementia or mild cognitive impairment. The MoCA is also better at indicating dementia in people with Parkinsons disease. The test is meant to be administered and scored only by a doctor, and is harder to find online than the MMSE.
Mini-Mental State Exam
While originally designed to be administered by medical professionals, family members can now administer the MMSE using their phone or laptop and receive accurate scoring results. Start here.
The SLUMS
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Join Us In The Fight Against Alzheimers
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Whos A Good Candidate
ApoE4 genotyping is not regularly used by most neurologists,Dr. Sabbagh says, and advisory groups recommend that people who do not havesymptoms not get tested.
But he does believe that the test can be used safely and without causing harm or distress in some people.
To me, people who are appropriate candidates are people with mild cognitive impairment, Dr. Sabbagh says. These are likely adults between the ages of about 50 and 75 who demonstrate early symptoms of Alzheimers disease and have already gone through a family history and neuropsychological testing with a neurologist.
I do order it to answer the question why not just what, he explains. Some people want to know why they got Alzheimers disease, so this can help explain that they inherited it and were born with the risk.
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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.
Does A Negative Result Mean A Person Won’t Get Dementia
No. A person with a negative result on a predictive genetic test may still develop dementia. The predictive test only shows whether a person will develop the type of dementia that is related to that specific single-gene change. It does not rule out the possibility of that person developing dementia because of other factors.
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Is There A Blood Test For Diagnosing Alzheimers
Researchers are working to diagnose Alzheimers disease at its earliest stages, before the onset of symptoms and even before toxic changes in the brain begin to cause damage.
Their efforts involve the search for new biomarkers measurable, accurate, and reliable indicators of disease that might appear on a blood test, for instance.
These biomarkers may one day help doctors and other clinicians detect Alzheimers early in the disease process, in the same way that increased cholesterol levels in the blood indicate heart disease risk.
For now, the use of Alzheimers biomarkers is mainly limited to research studies, although doctors sometimes use them in clinical practice to help confirm an Alzheimers diagnosis.
Researchers currently use blood tests to look for the presence of certain proteins associated with Alzheimers, including beta amyloid and tau . Scientists are getting closer to developing blood tests that could be used as a routine tool for identifying Alzheimers or screening people who are at risk of developing the disease.
Another biomarker involves cerebrospinal fluid , the clear liquid that surrounds the brain and spinal cord, which can be analyzed for the presence of Alzheimers-related proteins. Tests measuring CSF biomarkers are more sensitive than blood tests and are particularly useful for the diagnosis of early onset Alzheimers.
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Is It Worth Getting A Genetic Test For Dementia Risk Variants
Genetic tests for dementia risk variants are not recommended. This is because knowing whether someone has genetic risk variants does not mean knowing for certain whether they will develop dementia. A person who has risk variants may have a higher risk of developing dementia, but even someone at a higher risk may never develop the condition.
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How Do I Access Local Alzheimers Resources
You can often find Alzheimerâs resources at local churches, senior centers, or other community organizations you can also join local support groups. Professional care services can also help, including companies, non-profits, or volunteer organizations.
In order to start things off on the right foot, it is helpful to first make a plan. Think through what you or your family needs help with. Prepare questions that will help you understand if the resources offered meet those needs. Then contact local organizations, ask them your questions, and find out how you can get started. These steps may take a bit of time, but itâs worth it to find the help that you and your family need.
Additional Brainguide Key Points
BrainGuide by UsAgainstAlzheimerâs was created to help people of all ages and from all communities understand brain health and Alzheimerâs disease, and it empowers you to take action.
BrainGuide provides a wide variety of resources for people seeking to manage their brain health, people worried about their own memory or the memory of someone they love, and those caring for loved ones with Alzheimerâs disease.
BrainGuide was created by UsAgainstAlzheimerâs â a leading advocacy organization that exists to conquer Alzheimerâs disease and will not rest until brain span equals life span for everyone. BrainGuide was developed with in-kind and financial support from Biogen.
BrainGuide is a platform that offers confidential memory questionnaires â taken over the phone or online in English or Spanish â followed by tailored education and resources based on the answers provided. The memory questionnaires do not provide a diagnosis.
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Evaluating Cognitive Impairment And Dementia
Screening includes office-based assessments of cognitive function, as well as laboratory testing and neuroimaging. All patients suspected of having dementia should have a physical examination, including a screening neurological examination and review of medications, as a part of the evaluation.
Quick Cognitive Screening Tests
Mini-Mental State Examination
The Mini-Mental State Examination is an 11-item test that takes five to 10 minutes to administer .
- Scoring: suggested cut-off of 24 or less out of 30 should raise concerns about possible dementia.
- Performance affected by age and education
- Test items that are most sensitive to detection: orientation to date , delayed word recall and intersecting pentagons
- Pros: familiar and takes a relatively short time to administer
- Cons: takes longer than other similar tests tests a limited number of cognitive domains often not sensitive to early cognitive change
Mini-Cog
The Mini-Cog is a first-line cognitive screen for primary care, although it has not been evaluated as extensively as the MMSE or the Montreal Cognitive Assessment. The Mini-Cog combines the delayed three-word recall test and the clock-drawing test .
Delayed three-word recall test
Clock-drawing test
This test involves one item, and takes one to two minutes to administer.
Benefits Of Getting A Diagnosis
Early detection and diagnosis of Alzheimers disease or another dementia is critical to ensuring proper support, care and treatment of the illness. It is also important because it allows people with the disease and their families to make key financial and care decisions while they are still functioning at the highest possible level.
The diagnosis of dementia often comes as a complete shock. However, many people feel relieved once they have identified the source of their worries after a diagnosis has been made.
Getting an early diagnosis will help you to move forward and gain more control over your life by taking the necessary steps to live better with the disease. Receiving an early diagnosis allows a person to:
- Understand the symptoms they are experiencing, and the changes that they can expect
- Gain access to information, resources and support
- Benefit from and explore treatment options
- Plan for the future
- Develop and engage support networks
- Maximize their quality of life.
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What Happens If A Doctor Thinks It’s Alzheimer’s Disease
If a primary care doctor suspects Alzheimers, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
- Neuropsychologists, who can conduct tests of memory and thinking.
Memory clinics and centers, including Alzheimers Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.
How Are You Addressing Privacy
Privacy is a top priority for BrainGuide. Thatâs why questionnaires are completely confidential. The answers provided by the user are stored anonymously to help BrainGuide understand usage, identify better ways to serve the community and improve our service. Transaction logs are kept for up to three days to support system processes and troubleshooting. You can review our full privacy policy here.
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Gathering A Complete Medical History
As with the treatment of any medical condition, physicians will ask for a rundown of a patients past and present health issues and all medications they are currently taking. The doctor will also take a brief family medical history to assess the patients risk of developing certain conditions due to genetic, lifestyle and environmental factors. For example, if a patients parent had early-onset Alzheimers disease, it increases the likelihood that the patient will also develop this disease.
Who Is Usagainstalzheimers
UsAgainstAlzheimerâs exists to conquer Alzheimerâs disease. Since our founding in 2010, we have taken on the toughest problems in the fight to end Alzheimerâs. Our work is driven by the urgency to find effective treatments and the prevention steps needed to reach the time where no one is lost to Alzheimerâs.
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Other Testing & Diagnoses
Aside from online tests, it is worth mentioning both blood tests and genetic tests. Currently, a definitive blood test does not exist for the US market. However, there have been some positive developments on this front and now blood tests in the US market are expected within 3 5 years.
Genetic testing does exist but does not provide a definitive answer as to whether someone has Alzheimers or dementia. Instead, genetic tests are helpful in telling individuals if they have a propensity to develop dementia based on their genetic makeup. A medical evaluation from a doctor is currently the only way for an individual to receive an Alzheimers or dementia diagnosis. Read more about blood tests, genetic tests and the process of receiving a medical diagnosis.
DementiaCareCentral.com was developed with funding from the National Institute on Aging . The site is for educational purposes, medical decisions should not be based on its content and its authors assume no liability for errors or omissions. Content cannot be reproduced without permission.©1995-2022.
From One P To Another P
Sarah McLeod works as a mental health provider for people living with Alzheimers. In an online interview, she said one of her main jobs is helping clients learn to do the hard things.
The toll on spouses and partners can be heavy financially, physically, socially and emotionally. Theres depression, anxiety, loneliness, grief and loss of intimacy.
The marriage relationship shifts beneath them. McLeod said one husband explains it this way: heres been a transformation from one P to another P. And what he means is that his role has changed from being a partner to being more of a parent.
McLeod said the caregiver needs support from someone they trust, someone that you feel safe with, that you can say ugly things to, hard things to, embarrassing, shameful things to, and theyre not going anywhere.
Support groups help, so does understanding the disease and how it progresses. One resource, the Alzheimers Association, has information and connections for people taking care of someone with the disease.
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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.