How Is Alzheimer’s Disease Diagnosed
Doctors use several methods and tools to help determine if a person with thinking or memory problems has Alzheimers disease. To diagnose Alzheimers, doctors may:
- Ask the person experiencing symptoms, as well as 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.
- Administer a psychiatric evaluation to determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Order blood, urine, and other standard medical tests that can help 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 rule out other possible causes for symptoms.
Doctors may want to repeat these tests to help best determine how the persons memory and other cognitive functions are changing over time. The tests can also help diagnose other causes of memory problems, 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.
People with memory problems should return to the doctor every six to 12 months.
Signs Of Dementia Seen 18 Years Before Diagnosis
From our Care and cure magazine – Autumn 2015, find out about very early signs of dementia.
Based on tests completed 13 to 18 years before the study ended, a lower score in a cognitive test was associated with an 85 per cent greater risk of future dementia.
This suggests that the development of Alzheimer’s disease may begin many years earlier than expected before symptoms are recognised.
‘Dementia often causes changes in the brain years before the symptoms become apparent. This study shows that there may be subtle indications of Alzheimer’s disease in thinking and memory as many as 18 years before a formal diagnosis could take place,’ says Dr Doug Brown, Director of Research and Development at Alzheimer’s Society.
‘This could mean there is a long window of opportunity for treatment in which we could one day halt or slow dementia.
‘Although these tests cannot accurately predict who will develop dementia, they could potentially be used to identify people at higher risk.’
What Are The Symptoms Of Younger Onset Dementia
The symptoms of dementia are similar no matter what age they start. They include:
- memory loss that interferes with daily life
- withdrawing from friends and family
- losing the ability to think clearly or make judgements
- language problems
- changes to behaviour
Many conditions can produce symptoms that are similar to dementia, such as vitamin and hormone deficiencies, depression, medication, infections and brain tumours.
You May Like: What Is Senility
Knowing The Stages Of Dementia Helps You Plan
Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.
The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.
On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.
It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.
Early Symptoms Of Dementia
Dementia is a collection of symptoms that can occur due to a variety of possible diseases. Dementia symptoms include impairments in thought, communication, and memory.
If you or your loved one is experiencing memory problems, dont immediately conclude that its dementia. A person needs to have at least two types of impairment that significantly interfere with everyday life to receive a dementia diagnosis.
In addition to difficulty remembering, the person may also experience impairments in:
Recommended Reading: What Color Represents Dementia
What Are Specific Care Needs At Each Stage
An individual may not require care assistance after the initial diagnosis of dementia, but that will change as the disease progresses and symptoms become worse. There are about 16 million unpaid caregivers of people with dementia in the United States. While many caregivers are providing daily help for family members, they also hire someone to help. There are many options of care assistance, such as in-home care, adult day care, and nursing home care. There is also financial assistance available.
Early Stage DementiaAs mentioned above, in the early stage of dementia a person can function rather independently and requires little care assistance. Simple reminders of appointments and names of people may be needed. Caregivers can also assist with coping strategies to help loved ones remain as independent as possible, such as writing out a daily to-do list and a schedule for taking medications. Safety should always be considered, and if any tasks cannot be performed safely alone, supervision and assistance should be provided. During this period of dementia, its a good idea for caregivers and loved ones to discuss the future. For example, a long-term care plan should be made and financial and legal matters put in place.
Resistance To Visiting A Doctor
Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else deny, there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate one’s memory problems. Others, with retained insight, may be afraid of having their fears confirmed.
Dealing with resistance to visiting the doctor
One of the most effective ways to overcome this problem is to find a physical reason for a visit to the doctor, preferably a check-up for a symptom that the person is willing to acknowledge, such as headaches or failing eyesight. Perhaps suggest an examination of the heart, a test for blood pressure or diabetes, or a review of long term medication. Another way is to suggest that it is time for you BOTH to have a physical check up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. Calm, caring attitude at this time can help overcome the person’s very real worries and fears.
If the person will not visit the doctor:
- Talk with other carers who may have had to deal with similar situations
- Contact the Aged Care Assessment Team
You May Like: Alzheimers Awareness Ribbons
Risk Reduction And Dementia Prevention
Recognition and management of risk for Alzheimers disease earlier in adult life is important to have the greatest impact.18 At this stage, lifestyle changes can be made that will slow or prevent the development of future disease.47 Vascular disease and dementia syndromes have many shared risk factors including hypertension, type 2 diabetes, smoking and poor diet and exercise habits. This has led the WHO to recommend combined implementation of their recent guidelines on risk reduction of cognitive decline and dementia with interventions related to the management of risk factors for cardiovascular disease and diabetes.8 While general screening is not recommended, individuals with these risk factors can be advised to improve lifestyle choices and control their modifiable risk factors to minimise their risk for future dementia as well as other chronic conditions. In addition, brain health should be protected throughout life by avoiding alcohol and substance abuse, supporting lifelong learning, and social interaction and stimulation in later life.
Duration Of Stages: How Long Do The Stage Of Alzheimers / Dementia Last
No two people with dementia experience the disease exactly the same way, and the rate of progression will vary by person and type of dementia. In addition, it is not uncommon for individuals to have mixed dementia, meaning they have more than one type. That said, there is a natural course of the disease, and over time the capabilities of all persons with dementia will worsen. Eventually, the ability to function goes away. Keep in mind that changes in the brain from dementia begin years before diagnosis, when there are no outward symptoms. This makes it difficult to know how much time a person has left, though there are ways to come close to knowing life expectancy.
|Life Expectancy by Dementia Type|
|2 to 8 years following pronounced symptoms|
Mild DementiaIn this early stage of dementia, an individual can function rather independently, and often is still able to drive and maintain a social life. Symptoms may be attributed to the normal process of aging. There might be slight lapses in memory, such as misplacing eyeglasses or having difficulty finding the right word. Other difficulties may include issues with planning, organizing, concentrating on tasks, or accomplishing tasks at work. This early stage of dementia, on average, lasts between 2 and 4 years.
Don’t Miss: Alzheimer’s Neurotransmitters
Variables Impacting Life Expectancy Calculations
Gender. Men dont live as long with Alzheimers as women. A study of more than 500 people diagnosed with Alzheimers disease between 1987 and 1996 found that women with Alzheimers live, on average, 20% longer than men. Age. Someone diagnosed at 65 lives an average of about eight years, while someone over 90 who gets a diagnosis typically lives about three-and-a-half more years. Strength of Symptoms at Diagnosis. If someone is showing especially severe dementia-related problems at the time of diagnosis, this usually leads to an earlier death. Someone who wanders, is prone to falling, and experiences urinary incontinence , will typically not live as long. A lower mini-mental state examination score at the time of diagnosis will also not live as long. Other Health Problems. A person with a history of heart problems or asthma or diabetes, for example, will not live as long as someone without those underlying issues.
Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
Don’t Assume It’s Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the symptoms are present. Strokes, depression, alcoholism, infections, hormone disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
Difficulty Completing Normal Tasks
A subtle shift in the ability to complete normal tasks may indicate that someone has early dementia. This usually starts with difficulty doing more complex tasks like balancing a checkbook or playing games that have a lot of rules.
Along with the struggle to complete familiar tasks, they may struggle to learn how to do new things or follow new routines.
Also Check: Does Coke Cause Alzheimer’s
Symptoms Of Mild Cognitive Impairment
Some people have a condition called mild cognitive impairment, or MCI. It can be an early sign of Alzheimers. But, not everyone with MCI will develop Alzheimers disease. People with MCI can still take care of themselves and do their normal activities. MCI memory problems may include:
- Losing things often
- Forgetting to go to events or appointments
- Having more trouble coming up with words than other people the same age
Learn more about Alzheimer’s disease from MedlinePlus.
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
You May Like: Ribbon Color For Dementia
How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
Types Of Lewy Body Dementia
It’s important to know which type of LBD a person has, both to tailor treatment to particular symptoms and to understand how the disease will likely progress. Clinicians and researchers use the “one-year rule” to help make a diagnosis. If cognitive symptoms appear at the same time as or at least a year before movement problems, the diagnosis is dementia with Lewy bodies. If cognitive problems develop more than a year after the onset of movement problems, the diagnosis is Parkinson’s disease dementia.
Regardless of the initial symptoms, over time, people with either type of LBD often develop similar symptoms, due to the presence of Lewy bodies in the brain. But there are some differences. For example, dementia with Lewy bodies may progress more quickly than Parkinson’s disease dementia.
Also Check: Purple Ribbon Alzheimer’s
What To Expect When You See A Gp About Dementia
A GP will ask about your symptoms and other aspects of your health.
They’ll also ask if you’re finding it difficult to manage everyday activities such as:
- washing and dressing
- cooking and shopping
- paying bills
If possible, someone who knows you well should be with you at your GP appointment, so they can describe any changes or problems they’ve noticed. They could also help you remember what was said at the appointment, if this is difficult for you.
Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as:
- an underactive thyroid
- side effects of some medicines
To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test.
You’ll also be asked to do a memory or cognitive test to check any problems with your memory or ability to think clearly.
Read more about the tests used to diagnose dementia.
Future Directions In Diagnosis Research
Considerable research effort is being put into the development of better tools for accurate and early diagnosis. Research continues to provide new insights that in the future may promote early detection and improved diagnosis of dementia, including:
- Better dementia assessment tests that are suitable for people from diverse educational, social, linguistic and cultural backgrounds.
- New computerised cognitive assessment tests which can improve the delivery of the test and simplify responses.
- Improved screening tools to allow dementia to be more effectively identified and diagnosed by GPs.
- The development of blood and spinal fluid tests to measure Alzheimers related protein levels and determine the risk of Alzheimers disease.
- The use of sophisticated brain imaging techniques and newly developed dyes to directly view abnormal Alzheimers protein deposits in the brain, yielding specific tests for Alzheimers disease.
Read Also: Color For Dementia Awareness
Evidence That Life Expectancy Calculators For Dementia Actually Work
It turns out that the length of time a person has before needing full-time care, before moving into a care community, and before dying can all be predicted somewhat accurately. This information, though not definitive, can help families get a general understanding of how to plan for the future and what to expect as the disease progresses.
In a study conducted at the department of neurology in Columbia University, groups of people with mild Alzheimers were followed for 10 years and assessed semiannually. Data from these assessments were plugged into a complicated algorithm. The people studied were tested for the following:
Mental status score Cognition and function Motor skills Psychology and behavior Basic demographic information
Other experiments have yielded similar results. A University of Kentucky study analyzed the records of more than 1,200 people with dementia and found that it was possible to accurately predict their life expectancy. Researchers looked at many variables including family history and medical problems like high blood pressure and heart disease, and ultimately realized it came down to three things:
age when the first symptoms appeared gender how impaired someone was when diagnosis was first made