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How To Get An Alzheimer’s Diagnosis

What Is The Burden Of Alzheimers Disease In The United States

How to get a diagnosis of dementia?
  • Alzheimers disease is one of the top 10 leading causes of death in the United States.2
  • The 6th leading cause of death among US adults.
  • The 5th leading cause of death among adults aged 65 years or older.3

In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimers disease.1 This number is projected to nearly triple to 14 million people by 2060.1

In 2010, the costs of treating Alzheimers disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4

Death rates for Alzheimers disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimers disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimers may be considerably higher.6

How Is Alzheimers Disease Treated

Medical management can improve quality of life for individuals living with Alzheimers disease and for their caregivers. There is currently no known cure for Alzheimers disease. Treatment addresses several areas:

  • Helping people maintain brain health.
  • Managing behavioral symptoms.
  • Slowing or delaying symptoms of the disease.

How Is Alzheimer’s Disease Diagnosed And Evaluated

No single test can determine whether a person has Alzheimer’s disease. A diagnosis is made by determining the presence of certain symptoms and ruling out other causes of dementia. This involves a careful medical evaluation, including a thorough medical history, mental status testing, a physical and neurological exam, blood tests and brain imaging exams, including:

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Nhs Recruits Reiki Healer

An NHS trust has been slammed after placing an ad for a reiki healer despite there being ‘no scientific evidence’ that it helps patients.

Manchester University Trust is looking for a ‘spiritual healer/reiki therapist’ on up to £26,000 a year. Reiki, which originated in Japan, is intended to relieve stress and pain by channelling ‘universal energy’ from a healer.

A charity is funding the position, but The Good Thinking Society, which challenges ‘pseudo-science’, insisted: ‘The NHS shouldn’t be endorsing it, even indirectly.’

NHS England said there was ‘no scientific evidence’ that reiki was an effective clinical treatment. The trust stressed that reiki ‘does not in any way replace established medical treatments’.

These included barriers due to visual or hearing impairment, difficulties in using the technology, and the person being assessed presenting differently on the phone compared to face-to-face.

One patient said: ‘Being told you have Alzheimers by a stranger on a TV screen is quite hard to take in.’

In the first lockdown, 62 per cent of services were closed for between one and six months.

Staff being redeployed or being unable to work due to the pandemic affected 83 per cent of services.

It resulted in a postcode lottery with fewer than half of patients 43 per cent getting all four in-clinic routine assessments. Seven per cent of patients had no in-clinic routine assessments at all or it was not documented.

Is It Dementia Or Mild Cognitive Impairment

Pin on Senior

Sometimes, when an older person is having memory problems or other cognitive issues, they end up diagnosed with mild cognitive impairment.

Mild cognitive impairment means that a persons memory or thinking abilities are worse than expected for their age , but are not bad enough to impair daily life function.

The initial evaluations for MCI and dementia are basically the same: doctors need to do a preliminary office-based cognitive evaluation, ask about ADLs and IADLs, look for potential medical and psychiatric problems that might be affecting brain function, check for medications that affect cognition, and so forth.

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Advocate Advocate And Advocatethen Advocate Again

Many families we spoke with who are living with young onset dementia told us it was especially important to advocate for a diagnosis.

âOne of my recommendations for folks who suspect this is going on is…be a strong advocate,â says Malcolm Allen, a care partner in Niagara region.

Advocating means speaking up and asking for more tests, referrals and information. Even when the doctor doesnât think itâs needed right away.

âIf you don’t, you’ll get shoved to the side,â says Allen. âFolks need to push hard to get additional testing done. And push to talk to physicians who actually understand dementia. If they have the least bit suspicion, then they need to do that.â

Even people who have worked in the health care system prior to dementia impacting their family can have challenges navigating the diagnostic process.

âThe day that it hit me that my husband had aphasia, I started to document, because Iâm a nurse,â Nancy Scott, a care partner in Winnipeg, says. âBut I had to push my doctor to get a referral to a neurologist. And the first neurologist dismissed us–he hadnât read my charting, he hadnât read my documentation. And when I tried for a second one, they declined.â

If you find this process difficult, you are not alone.

How To Get A Dementia Diagnosis

The dementia diagnosis process can vary for everyone. This page describes the typical steps involved in getting a diagnosis, including what might happen if you are referred to a specialist.

For many people, getting a dementia diagnosis can be quite simple and take just a few weeks. For others it can take much longer sometimes more than a year.

There isnt yet a simple test for dementia, so a diagnosis is normally based on a mixture of different types of assessment.

You will have several tests to give healthcare professionals enough information to tell you what is causing your symptoms.

For most people, the process usually follows these steps:

  • Your GP or another health professional at the GP surgery will carry out an initial assessment. If they think its possible you might have dementia, they will refer you to a local memory service, which has medical staff who specialise in dementia.
  • A specialist will test your memory and see how you answer different types of questions. You dont need to prepare for this. You may have a scan to check for changes in your brain.
  • The specialist will tell you what they think is causing your symptoms, based on what you have told them and the results from your tests. You will then be able to access the support that is right for you.
  • But the assessment process can vary, and will not be the same for everyone.

    Talking to your GP about dementia

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    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

    Are Genetic Tests Part Of The Diagnostic Process

    Delivering an Alzheimer’s Disease Diagnosis

    A doctor will not routinely order a genetic test to diagnose Alzheimers disease. A gene may raise your risk of Alzheimers though lifestyle and environment almost always play a role, too but a genetic test does not reveal whether you have or will ever develop the disease.

    Neurologists may order genetic tests in unusual situations, such as when they suspect specific mutations in one of three genes. These rare mutations account for an estimated 1 percent or less of all Alzheimers cases and tend to result in early-onset Alzheimers, in which symptoms develop before age 65.

    Anyone who wants to have a genetic assessment can now take a home screening test.

    In 2017 the U.S. Food and Drug Administration announced approval of the first direct-to-consumer genetic test, from a company called 23andMe. Tests analyze a saliva sample, submitted in the mail, for the presence of gene variants that raise the odds of developing different diseases or conditions. One of these is the APOE-e4 gene, a risk factor for Alzheimers.

    However, many people who have the APOE-e4 gene never develop Alzheimers, and many people who develop Alzheimers do not possess the APOE-e4 gene. So while the gene is known to increase the risk of developing Alzheimers, individuals must be very careful with how they interpret the finding.

    The group advises anyone interested in home screening to consult a genetics counselor to better understand the implications of taking the test and to put any findings in context.

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    Early Warning Signs And Diagnosis

    Alzheimers Disease can be caught in the early stageswhen the best treatments are availableby watching for telltale warning signs. If you recognize the warning signs in yourself or a loved one, make an appointment to see your physician right away. Brain imaging technology can diagnose Alzheimers early, improving the opportunities for symptom management.

    Keep A Journal Or Diary Of Your Symptoms And Bring It To Medical Appointments

    Many doctors want to know when your memory issues or thinking problems began, and how often they happen.

    They also want examples of how your memory issues or thinking problemsâor other symptomsâare having an impact on your day-to-day life. And doctors need you to be specific and honest about your experience, as they can only base their decisions on what you tell them.

    Writing your symptoms down in a daily journal or diary can help with this. And as a result, it can help speed up your diagnosis. It can remind doctors of those important facts: when your symptoms began, how they progressed, and how they are impacting your day-to-day life, including your job.

    And the journal or diary doesnât have to be on paper! It can also be in a notes app on your phone, or whatever other tool works for you.

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    What Are The Benefits Of An Early Alzheimer’s Diagnosis

    Alzheimers disease slowly worsens over time. People living with this disease progress at different rates, from mild Alzheimers, when they first notice symptoms, to severe, when they are completely dependent on others for care.

    Early, accurate diagnosis is beneficial for several reasons. While there is no cure, there are several medicines available to treat Alzheimers, along with coping strategies to manage behavioral symptoms. Beginning treatment early in the disease process may help preserve daily functioning for some time. Most medicines work best for people in the early or middle stages of the disease. Learn more about Alzheimers medications.

    In addition, having an early diagnosis helps people with Alzheimers and their families:

    Complementary And Alternative Therapies

    Alzheimerâs disease

    We may recommend therapies that are complementary or alternative to ease symptoms. Providers at the Layton Center work with colleagues at OHSUs Oregon Center for Complementary and Alternative Medicine in Neurological Disorders. Our research focuses on finding ways to delay or slow Alzheimers and other dementias.

    Therapies might include:

    • Acupuncture: Inserting very thin needles at specific points on the body may relieve pain and other symptoms. Although more research is needed, a 2015 review of studies found that acupuncture is safe and effective for people with Alzheimers.
    • Diet: A low-fat diet with plenty of fruits and vegetables can protect heart and brain health. Research with brain scans showed the benefit of the Mediterranean diet. People who followed the diet had less buildup of an Alzheimers-related protein than those on a traditional Western diet.
    • Meditation: A recent study showed that daily meditation for three months can help people with Alzheimers. People in the study showed improvement in memory and thinking. Those who continued for three more months maintained or improved these gains.
    • Supplements: A few studies have shown modest benefits from taking nutritional or herbal supplements. This is an area of continued research.

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    Early Diagnosis And Drug Treatment

    Talking about being diagnosed with dementia at the age of 50, Norman McNamara says on his YouTube video:

    Being diagnosed with something like this absolutely devastates you, but for me diagnosis and this is going to sound really strange was probably the best news I had at the time. Because… I thought I was losing my mind. I thought there was a conspiracy against me. I was right and everybody else was wrong. An early diagnosis of dementia is so, so important. Once diagnosed, I knew what I was up against. As they say: know your enemy. If I hadnt been diagnosed early and I hadnt been seen by consultants on a regular basis, I wouldnt be as well as I am today. I dont know what my future holds, but at least Im prepared for it.

    You may also be interested to read Supporting carers at the time of diagnosis in the section on Carers of people with dementia.

    At Your Appointment With The Specialist

    It’s important to make good use of your time with the specialist. Write down questions you want to ask, make a note of any medical terms the doctor uses, and ask if you can come back if you think of more questions later. Taking the opportunity to go back can be very helpful.

    The specialist may organise more tests. One of these might be a brain scan, such as a CT scan, or an MRI scan.

    They may also do further, more detailed memory tests.

    If the specialist is still not certain about the diagnosis, you may need to have further, more complex tests. But most cases of dementia can be diagnosed after these assessments.

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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.

    Support For Family And Friends

    Finding dementia support after a diagnosis

    Currently, many people living with Alzheimers disease are cared for at home by family members. Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.

    Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimers disease at home can be a difficult task and may become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimers disease often need more intensive care.

    You can find more information about caring for yourself and access a helpful care planning form.

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    What Is Known About Alzheimers Disease

    Scientists do not yet fully understand what causes Alzheimers disease. There likely is not a single cause but rather several factors that can affect each person differently.

    • Age is the best known risk factor for Alzheimers disease.
    • Family historyresearchers believe that genetics may play a role in developing Alzheimers disease. However, genes do not equal destiny. A healthy lifestyle may help reduce your risk of developing Alzheimers disease. Two large, long term studies indicate that adequate physical activity, a nutritious diet, limited alcohol consumption, and not smoking may help people. To learn more about the study, you can listen to a short podcast.
    • Changes in the brain can begin years before the first symptoms appear.
    • Researchers are studying whether education, diet, and environment play a role in developing Alzheimers disease.
    • There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. Heres 8 ways.

    How To Get A Diagnosis For Young Onset Dementia

    Research shows it can take people with young onset dementia 57% longer to get a diagnosis compared to older people with dementia. Here are some ways to try and get a diagnosis soonerâalong with faster access to supports and therapies.

    According to the Alzheimer Society of Canada, there are at least 28,000 people in Canada living with young onset dementia.

    But the real number is probably even higher.

    Why? Because people living with young onset dementia are often misdiagnosed. Doctors can mistake young onset dementia for depression, stress, menopause or other issues.

    A Dutch study has shown it can take an average of 4.4 years for younger people to be diagnosed with dementia. This is 57% longer than it takes to diagnose dementia in older people. And it delays access to treatment and support.

    Recent research also shows that in high-income countries, Black people, Indigenous people and people of colour are at higher risk of being underdiagnosed for dementia than white people are. Also, BIPOC people are more likely to be diagnosed at a later stage of dementia.

    Barriers to diagnosis can include lack of culturally appropriate services, language and communication barriers, and healthcare provider bias, among other factors.

    Here are some tips for getting an accurate diagnosis more quickly.

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