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.
Your Loved One Has A Fall
For people living with dementia, the risk of falling is increased. While some falls don’t cause any injury, other falls can cause concussions or head injuries, hip fractures, or neck injuries. If your family member with dementia hit her head or neck in the fall, lost consciousness, can’t move her arms or legs, has significant pain or can’t bear weight, you will likely need to call 911 for medical evaluation and possible transport to the hospital.
What Is Dementia Symptoms Types And Diagnosis
Dementia is the loss of cognitive functioning thinking, remembering, and reasoning to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.
Dementia is more common as people grow older but it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia.
There are several different forms of dementia, including Alzheimers disease. A persons symptoms can vary depending on the type.
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Treatment For Mild To Moderate Alzheimers
Treating the symptoms of Alzheimers can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimers symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimers disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimers progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimers may respond better to one drug versus another.
Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimers before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.
Can Dementia Be Prevented
Although dementia cannot be prevented, living a health-focused life might influence risk factors for certain types of dementia. Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, controlling blood sugar, staying at a healthy weight basically, staying as healthy as one can can keep the brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:
- Follow a Mediterranean diet, which is one filled with whole grains, vegetables, fruits, fish and shellfish, nuts, beans, olive oil and only limited amounts of red meats.
- Exercise. Get at least 30 minutes of exercise most days of the week.
- Keep your brain engaged. Solve puzzles, play word games, and try other mentally stimulating activities. These activities may delay the start of dementia.
- Stay socially active. Interact with people discuss current events keep your mind, heart, and soul engaged.
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Your Loved One Shows Signs Of Pain Or Discomfort
Be vigilant about looking for signs of discomfort or pain. This is important for all caregivers, but especially for those who are caring for people with dementia because of their word-finding difficulties. Pain may be demonstrated by anger, irritation, resisting care, yelling out or increased restlessness. Adequate pain control is important for your loved one’s quality of life.
Symptoms Of Alzheimers Disease
- Problems recognizing friends and family
- Impulsive behavior
- Difficulty resisting the impulse to use or touch objects
- Compulsive eating
- Trouble following instructions or learning new information
- Hallucination or delusions
- Poor judgment
Typical age of diagnosis for Alzheimers disease: Mid-60s and above, with some cases in mid-30s to 60s
Typical age of diagnosis of frontotemporal dementia: Between 45 and 64
Typical age of diagnosis of Lewy body dementia: 50 or older
Typical age of diagnosis of vascular dementia: Over 65
Also Check: Do Dementia Patients Tell The Truth
There Is Unplanned Weight Loss Or Gain Of More Than A Few Pounds
If your loved one is putting on the pounds or losing them without a noticeable change in diet, this could be a cause for concern. While excess pounds can indicate things like hidden snacking, hoarding food or water retention due to congestive heart failure, weight loss in dementia has been correlated with a general decline in condition and should be investigated.
Tips For Visiting The Gp
- Write down things you want to talk about before you go. It can be difficult to remember everything you want to say.
- Make a note of anything important the doctor says. You might want to write down any medical terms, for example.
- Ask the doctor to explain in simpler language if you do not understand what they are telling you.
- If you have any customs or religious beliefs that may affect treatment, mention this to your GP.
- Ring the surgery after the appointment if there is anything you forgot to ask. You may be able to speak to the doctor on the telephone rather than have to make another appointment.
- Ask to see the named GP that has been allocated to you.
Seeing the same GP regularly should be better for you. Sometimes this will not be possible, depending on which doctor is available at the surgery.
How the GP can support a person with dementia
Information about the different kinds of support available from a GP for a person with dementia.
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Learn About Neurology Specialists
Though many primary care physicians are able to make an initial diagnosis of dementia and provide basic care for memory-impairing diseases, working with a specialist in brain disorders and taking advantage of the physicians more extensive experience is a necessity for more thorough treatment. According to Dr. Piero G. Antuono, Silverado Brookfield Medical Director, those seeking the most thorough treatment and care of dementia are best served by consulting doctors with formal training and experience in geriatrics, neurology or psychiatry.
If Youre Worried About Possible Dementia
Lets say youre like the man I spoke to recently, and youre worried that an older parent might have dementia. Youre planning to have a doctor assess your parent. Heres how you can help the process along:
- Obtain copies of your parents medical information, so you can bring them to the dementia evaluation visit. The most useful information to bring is laboratory results and any imaging of the brain, such as CAT scans or MRIs. See this post for a longer list of medical information that is very helpful to bring to a new doctor.
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Tips For Choosing A Medical Provider
Once youve developed a potential list of AD providers, its time to contact their office and determine if they could be the right doctor for your loved one. Examples of questions to ask on the first phone call can include:
- What insurance types do you accept?
- What types of services are offered for those with AD?
- Are there any special qualifications or behavioral needs your practice works with or doesnt work with ?
- How is the staff trained in AD and dementia? Do any support staff members have special credentials related to AD care?
Another deciding factor could be the level of experience the provider has in treating people with AD. Some seek board certification in gerontology or in their chosen medical field. This means the doctor has undergone continuing education and further testing to prove they have extensive knowledge on a particular subject.
Many medical practices will also offer a free meet and greet appointment during which you meet the medical provider and tour the office to ensure its the best fit for a loved one. You may also wish to ask if the provider can give you references or testimonials from their patients. Speaking to others can help you determine what it would be like to see this doctor on a regular basis.
Choosing The Right Doctor
Choosing a doctor is a very important decision, one that is best made when you are healthy. Not only do you want a doctor who is competent and well-trained particularly in the types of health issues you have but you also want one who gives you the time necessary to listen to and address your health problems or questions. A doctor who knows you and is familiar with your health concerns is a good starting point however, some experts believe that your long-time family physician is NOT the best person to go to for a diagnosis, because the familiarity he or she has with you or your loved one may affect the doctors medical judgment. If you have a family doctor that you know and trust, you may want to ask him or her for a referral to a doctor who specializes in diagnosing Alzheimers disease. Seek out a physician whose specialty is geriatrics, neurology, or clinical psychiatry, because these types of doctors are generally well-trained in the diagnosis of Alzheimers and other related dementias. Click here to use the Resource Locator tool to find physicians near you.
There are a number of things you can do to help ensure youre seeing the right doctor:
Your Best Choice May Not Be Your Family Doctor
Although a preliminary diagnosis may begin with your primary care doctor, theyll most likely refer you to a specialist. Some people express a preference to continue seeing their family doctor because its someone they know and trust. Others may feel disheartened by their diagnosis and question the use of seeing a specialist.
Thats an understandable concern, but misinformed. New research is published every month about findings in Alzheimers treatment. Although scientists havent yet found a cure, they have uncovered much that is helpful for people who have been diagnosed.
Dementia is a rapidly developing area of study, and its likely that the family doctor wont be as up to date with the latest information. This may be especially true in the case of early onset Alzheimers, where symptoms and treatment are less well-known among most regular doctors.
Seeing a specialist will ensure your loved one benefits from the most recent therapies and medications.
Are Diagnostic Tests Insured
Some insurance and managed care plans will cover the costs of a diagnostic assessment for Alzheimers disease. Check with your health plans administrator to understand the policies and procedures.
Medicare, the governments health-insurance program for people 65 and up, and Medicaid, the joint federal-state medical-assistance program for people with limited income or assets, typically reimburse doctors for a diagnostic assessment and certain medical tests needed to determine if a patient has Alzheimers disease provided your doctor accepts these plans as payment. Talk to your doctor or doctors staff about what is covered.
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You Notice Increased Confusion That’s Different Than Normal
Although your loved one has dementia, you still might see those times where their confusion is more prominent or severe than normal. This could be related to a medical condition that’s treatable, so it’s important that the reason for this cognitive decline is investigated by the physician. It is often helpful to the doctor if you’re able to provide an example or two of the cognitive decline/confusion, rather than just a statement that “they’re more confused.”
How To Choose An Alzheimer’s Doctor
When it comes to Alzheimer’s disease, choosing an Alzheimer’s doctor is crucial to receiving the proper care and treatment. But who do you see? The medical field has split itself into so many specialties that finding the right professional can be a daunting task.
Your primary care physician is often the best place to start if more focused testing or treatment is needed, you may be referred to a specialist. However, primary care physicians don’t always refer patients to specialists, even when it could help clarify a diagnosis or supplement primary treatment. In these cases, its up to you to sort through the maze of medical professionals.
If you feel that you want more specialized care, use the following guide to help you determine what kind of expert will best meet your needs. Of course, always check to make sure professionals are licensed or certified to practice their specializations.
Can Dementia Be Diagnosed During A Single Visit
So can dementia be diagnosed during a single visit? As you can see from above, it depends on how much information is easily available at that visit. It also depends on the symptoms and circumstances of the older adult being evaluated.
Memory clinics are more likely to provide a diagnosis during the visit, or shortly afterwards. Thats because they usually request a lot of relevant medical information ahead of time, send the patient for tests if needed, and interview the patient and informers extensively during the visit.
But in the primary care setting, and in my own geriatric consultations, I find that clinicians need more than one visit to diagnose dementia or probable dementia. Thats because we usually need to order tests, request past medical records for review, and gather more information from the people who know the senior being evaluated. Its a bit like a detectives investigation!
Compassionate Care For Patients With Memory Loss
Watching a loved one experience memory loss is challenging, and the journey can be emotionally taxing for both you and the person going through it. While this is difficult, it is important to keep in mind that living with memory loss does not mean living in misery. A cure for dementia and Alzheimers may not yet be available, but we have come a long way in making life easier and more comfortable for those who go through it.
Our compassionate team of medical professionals provide comprehensive care and treatments for patients with memory loss. In addition to caring for the patient, we are also here to help their loved ones with counseling and referrals to community resources. We know this is a difficult time for all involved, and our goal is to help your entire family through it.
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How Does Dementia Affect The Brain
It depends on the cause of dementia. With Alzheimers, it affects the brain by causing neurodegenerationor damage and death to specific brain cells in specific parts of the brainthat then spreads over time. We also see a loss of synapses in the brain that occurs out of proportion to the death of those brain cells. The leading view of Alzheimers is that its related to the formation of amyloid protein in the brain, but that is disputed. There are other changes happening, such as tau protein deposits, called tau tangles. Even if you believe the amyloid protein hypothesis, then you can ask why do the protein buildups occur ? We dont fully know.
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Why Choose Upmc In Central Pa For Dementia And Alzheimer’s Disease Care
At UPMC, our neurology specialists provide expert diagnosis and manage memory, mood, behavior, and cognitive problems that are caused by Alzheimer’s disease and dementia. Our neurologists and neuropsychologists will work together to perform a complete assessment to evaluate several areas of brain function, including personality, memory, cognitive ability, emotions, problem-solving, and reasoning.
After you receive the results of your assessment, your neurology team will work closely with you and your loved ones to develop a personalized care plan. Although there is no cure for Alzheimer’s disease and dementia — and no way to slow down the progression of the disease — our specialists use the latest medications and therapies to help patients and caregivers manage symptoms such as depression, behavioral problems, and sleeplessness.
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What Doctors Need To Do To Diagnose Dementia
Now that we reviewed the five key features of dementia, lets talk about how I or another doctor might go about checking for these.
Basically, for each feature, the doctor needs to evaluate, and document what she finds.
1. Difficulty with mental functions. To evaluate this, its best to combine an office-based cognitive test with documentation of real-world problems, as reported by the patient and by knowledgeable observers
For cognitive testing, I generally use the Mini-Cog, or the MOCA. The MOCA provides more information but it takes more time, and many seniors are either unwilling or unable to go through the whole test.
Completing office-based tests is important because its a standardized way to document cognitive abilities. But the results dont tell the doctor much about whats going on in the persons actual life.
So I always ask patients to tell me if theyve noticed any trouble with memory or thinking. I also try to get information from family members about any of the eight behaviors that are common in Alzheimers. Lastly, I make note of whether there seem to be any problems managing activities of daily living and instrumental activities of daily living .
Driving and managing finances require a lot of mental coordination, so as dementia develops, these are often the life tasks that people struggle with first.
Checking for many of these causes of cognitive impairment requires laboratory testing, and sometimes additional evaluation.