Spinal Fluid Tests Are Available Now And Paid For By Insurance
Perhaps Ive convinced you that you dont need to rush out and have an expensive amyloid brain scan. But there are situations when it is important to find out if you or a loved one has Alzheimers, versus another brain disease that would be treated differently. In these situations, we often use a spinal fluid test that is quite good at being able to distinguish Alzheimers from other brain diseases affecting thinking and memory.
To obtain the spinal fluid, you need to undergo a lumbar puncture, more commonly known as a spinal tap. Although it may sound frightening, it is actually a perfectly safe test. You simply sit or lie down on your side with your back to the doctor and curl into a little ball by bringing your shoulders down and your knees up. The doctor finds the right spot, cleans the area well, gives you some numbing medicine, inserts a thin needle, and takes out a small amount of spinal fluid, which is sent to a lab for analysis.
The Brief Alzheimer’s Screening Test
This short screening asks the test taker to repeat three words immediately after hearing them. Next, two tasks that distract from those three words are performed: a short version of the verbal fluency test where the person is asked to name as many animals as they can in 30 seconds and spelling “WORLD” backward. Finally, the person is asked to remember and recite the three words from the beginning of the screening process.
The Gerontological Society Of America Toolkit
The Gerontological Society of America recently published a comprehensive toolkit as a resource to assist primary care physicians to detect, diagnose, and manage persons with dementia. The 4-step program is referred to as the Kickstart-Assess-Evaluate-and Refer program.13
As a complement to the GSA toolkit, Maslow and Fortinsky14;discussed ways in which non-physician care providers can help increase early detection of older persons with dementia. In particular, they emphasized how non-physician healthcare providers can play a role in the diagnostic process and in providing the necessary guidance and support which is very important when individuals are faced with this diagnosis. Maslow and Fortinsky reasoned that, to optimize earlier diagnoses, non-physician healthcare providers can help optimize the systematic detection and referral of persons with cognitive impairment to the appropriate care provider and community resource.
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Can Dementia Suddenly Get Worse
The progression of dementia depends on the underlying disease. Some diseases have a rapid progression. Others progress more slowly. Any sudden change with either slow or rapid progression should be evaluated for another cause. In most cases, changes with dementia may seem like they came out of the blue when they actually may have been slowly developing in the background. The best way to prepare for changes and manage expectations is through information. Your doctor and medical team will be a valuable resource. There are a variety of educational resources that are also available through the Alzheimer’s Association.
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.
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When To See A Doctor
If you or a loved one is exhibiting symptoms that could potentially be a result of Alzheimers or other types of dementia, consult a physician as soon as possible. Since current medications work best in the early stages of the disease, early screening and diagnosis are important.
Once a patient receives a diagnosis of Alzheimers disease, the next step is to find out whether treatments are available.
No Harm Done By Dementia Screening
When someone begins exhibiting symptoms of dementia, a family member or loved one may bring them to the doctor to get a memory test. Often, however, people who are at risk of developing dementia or who are already experiencing the disease dont get screened for dementia early on.
There has also been some concern that screening every older adult who walks into primary care for cognitive impairment could cause anxiety especially if the patient doesnt want to know whether they have dementia, or are at a high risk of developing it.
The study examined dementia screenings in rural, suburban and urban primary care clinics throughout Indiana. The main finding of the report was that primary care dementia screening didnt increase anxiety or depression among the people studied and the researchers concluded they found no harm in screening for Alzheimers and other types of dementia.
Dementia screening provides awareness for the patient and their family, allowing them to take action including advance care planning and we now know that the screening does not harm the patient, Nicole Fowler, associate director of the Indiana University Center for Aging Research at Regenstrief Institute, said in a news release. Fowler is also an assistant professor of medicine at IU School of Medicine.
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What Diagnosis Falls Under Alzheimer’s Disease
Alzheimers disease is a diagnosis in itself. When it is noticeable clinically and identified early on, the formal diagnosis may be Mild Cognitive Impairment due to Alzheimers disease which may later develop into a diagnosis of dementia due to Alzheimers disease.
Demographics And Cognitive Screening
A total of 705 individuals were scheduled for screening appointments across the six 20172018 Memory Screening Day events . One hundred thirty-one individuals failed to keep their scheduled appointment, and 574 participants completed screening. The mean age of those who completed screening was 74.5years , and the mean level of education was 16.1years . There were 252 men and 322 women . Although screening was targeted towards those age 65 or older , a small number of younger individuals were allowed to participate due to a positive family history of dementia and significant anxiety related to their cognitive function. We decided to leave them in the study for the sake of completeness in describing our true experience in the Memory Screening Day events. The age distribution of those screened is shown in Fig.;. There were 95 aged 6569years , 309 aged 7079years , 118 aged 8089years , and 15 aged 90years or older . Almost half of those screened reported a positive family history of dementia , and approximately half answered yes to concern about memory by yourself or others on the MCQ . The average score on the MCQ was 2.2 .
Fig. 1
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Do Genes Cause Diseases
Genetic mutations can cause diseases. If a person inherits a genetic mutation that causes a certain disease, then he or she will usually get the disease. Sickle cell anemia, cystic fibrosis, and some cases of early-onset Alzheimer’s disease are examples of inherited genetic disorders.
Other changes or differences in genes, called genetic variants, may increase or decrease a person’s risk of developing a particular disease. When a genetic variant increases disease risk but does not directly cause a disease, it is called a genetic risk factor.
Identifying genetic variants may help researchers find the most effective ways to treat or prevent diseases such as Alzheimer’s in an individual. This approach, called precision medicine, takes into account individual variability in genes, environment, and lifestyle for each person.
The expression of geneswhen they are switched on or offcan be affected, positively and negatively, by environmental and lifestyle factors, such as exercise, diet, chemicals, or smoking. The field of epigenetics is studying how such factors can alter a cell’s DNA in ways that affect gene activity.
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.
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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.
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- Goal: is to have all important clinically relevant topics in one place for ease of access.
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Related Video And Images
- Illustration of amyloid beta and tau proteins in the brain. Image credit: National Institute on Aging, NIH
- Illustration of how Alzheimer disease spreads in the brain. Image credit: National Institute on Aging, NIH
- A comparison of a healthy brain and a brain from a person with severe Alzheimer disease. Image credit: National Institute on Aging, NIH
Is Dementia A Mental Illness
Dementia is a mental health disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders. In 2013, the American Psychiatric Association changed the name to Major Neurocognitive Disorder, which is a mouthful. The change was made in order to provide a clearer description of the problem. Whats most important to know is that dementias can involve changes to emotions, behaviors, perceptions, and movements in addition to memory and thinking.
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Blood Tests To Check For Other Conditions
Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia.
In most cases, these blood tests will check:
- liver function
- haemoglobin A1c
- vitamin B12 and folate levels
If your doctor thinks you may have an infection, they may;also ask you to do a urine test or other investigations.
Read more about;blood tests.
Detecting Alzheimers Gets Easier With A Simple Blood Test
New assays could reduce the need for costlier, more invasive brain scans and spinal fluid measures
When a patient complains of forgetfulness, a neurologist might not know immediately whether it results from normal aging, reduced blood flow to the brainor, more ominously, Alzheimers disease. For much of the past century, a definitive Alzheimers diagnosis could only be made during an autopsy. Brain imaging and spinal fluid tests now make it possible to spot the disease in patients even before the initial symptoms appear. But these invasive tests are expensive and generally limited to research settings that are not part of routine care for the millions of people suffering from the most common neurodegenerative disorder.
An era in which an Alzheimers diagnosis can begin in a doctors office is now arriving. Advances in technologies to detect early signs of disease from a blood sample are helping doctors to identify the memory-robbing disorder more accurately and to screen participants more quickly for trials of potential treatments for the more than five million people in the U.S. afflicted with Alzheimers.
The development of a blood-based test for Alzheimers disease is just phenomenal, says Michelle Mielke, a neuroscientist and epidemiologist at the Mayo Clinic. The field has been thinking about this for a very long time. Its really been in the last couple of years that the possibility has come to fruition.
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Studies Find Sage Reliable
Researchers from;Wexner;Medical Center at Ohio State University recently reported that over 1,000 people;took the test over a five year period.
In that time, the test detected early signs of cognitive issues in 30% of the participants. Dr. Douglas;Scharre;reaffirmed his confidence in the test;saying, What we found was that this SAGE, self-administered test correlated very well with the very detailed cognitive testing.
When the test is repeated over time, doctors can monitor their patients and detect slight changes in cognitive ability. Scharre went on to say, If we see this change, we can catch it really early, and we can start treatments much earlier than we did without a test.
Because early detection is crucial to managing and treating Alzheimers, SAGE could be an essential tool in slowing the progression of the disease.
Do you think;SAGE is a valuable tool in the early diagnosis of Alzheimers?;Wed like to hear;your thoughts in the comments below.
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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.
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What Is Alzheimer Disease
Alzheimer disease is an irreversible form of dementia characterized by memory loss, a progressive decline in intellectual ability, deteriorating language and speech skills, and personality and behavioral changes that eventually interfere with daily living. Currently, Alzheimer disease has been estimated to affect more than 5.5 million Americans over the age of 65 and about 200,000 under the age of 65.
Although some aspects of
Alzheimer disease is an irreversible form of dementia characterized by memory loss, a progressive decline in intellectual ability, deteriorating language and speech skills, and personality and behavioral changes that eventually interfere with daily living. Currently, Alzheimer disease has been estimated to affect more than 5.5 million Americans over the age of 65 and about 200,000 under the age of 65.
Although some aspects of AD mimic changes found in the brain as we age, AD is not a normal part of the aging process. Nerve cell injury and death occur due to the build-up of abnormal protein structures in the brain called amyloid plaques, also known as;senile plaques,;and neurofibrillary tangles. The destruction of nerve cells also results in decreased levels of substances called neurotransmitters that help transmit brain signals. Over time, AD results in decreased interaction between different areas of the brain.
Their articles expand the definition of Alzheimer disease to include three stages:
How Accurate Is It
This quiz is;NOT a diagnostic tool. Mental health disorders can only be diagnosed by licensed healthcare professionals.
Psycom;believes assessments can be a valuable first step toward getting treatment. All too often people stop short of seeking help out of fear their concerns arent legitimate or severe enough to warrant professional intervention.
If you think you or someone you care about may be suffering from dementia or any other mental health condition, PsyCom.net strongly recommends that you seek help from a mental health professional in order to receive a proper diagnosis and support. For those in crisis, we have compiled a list of resources where you may be able to find additional help at: https://www.psycom.net/get-help-mental-health.
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Epidemiology And Risk Factors
After 65 years of age, the lifetime risk of developing dementia is approximately 17 to 20 percent; 70 percent of patients with dementia have Alzheimer disease, 17 percent have vascular dementia, and 13 percent have a combination of dementia with Lewy bodies, Parkinson-related dementia, alcoholic dementia, or frontal lobe dementia.4,5 The transitional state between normal cognition and early Alzheimer disease is called mild cognitive impairment, which is defined as memory impairment without meeting criteria for dementia. Each year, 10 to 15 percent of patients with mild cognitive impairment develop Alzheimer disease.6 Alzheimer disease affects 5.3 million Americans, and is the sixth leading cause of death.4 Median survival time after diagnosis of dementia is 4.5 years.7
Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, and lower educational level.810 The greatest risk factor for dementia is increasing age. In persons 71 to 79 years of age, the prevalence is approximately 5 percent, increasing to 37 percent in persons older than 90 years.5 Having a college education has been shown to delay cognitive dysfunction by two years, compared with having less education.10 The presence of the apolipoprotein E4 genotype can increase the risk of dementia two- to 10-fold, and chronic anticholinergic use is associated with a somewhat increased risk .5,9