As Alzheimer's kills brain cells, so the brain shrinks in size.
How Alzheimer's Is Diagnosed
||How Is Alzheimer's Diagnosed?
There is no single test for Alzheimer’s. A team of doctors conduct a battery of physical, neurological and psychiatric tests to rule out other causes of dementia (some of which may be treatable). Only once all other causes have been ruled out, is a diagnosis considered. The diagnosis in reality is a bit of an educated guess. At present the only way to confirm the condition conclusively is to look at the brain during an autopsy.
In actual practice is it estimated that 25 to 40 percent of people with Alzheimer’s are misdiagnosed. Many may in fact have treatable or reversible conditions that can cause Alzheimer-like symptoms such as thyroid disease, vitamin B deficiency, alcoholism or over-medication. Health professionals believe that only when a detailed examination, as described below, is carried out, can about 90 percent of Alzheimer cases be accurately diagnosed. Unfortunately not all physicians order all the tests, and hence the high rates of misdiagnosis.
If your primary care doctor suspects you may have symptoms of Alzheimer's, he will refer you to one or several specialists for a detailed examination. Those specialists include:
Physical Exam And Diagnostic Tests
A neurologist will closely evaluate the brain to look for signs of diseases, other than Alzheimer's, that could be responsible for problems. This includes brain tumors, mini-strokes, large strokes, fluid accumulation and Parkinson’s' disease. He will test your reflexes, speech, eye movement, coordination, muscle strength and tone. He may also order images to be taken of the brain with either an MRI scan or CT scan.
A geriatric psychiatrist is a medical doctor who specializes in diagnosing and treating mental disorders in older people. While Alzheimer's is not a mental illness, it causes symptoms similar to mental illnesses such as agitation, depression, hallucinations and anxiety. If someone is having these experiences, it may help to have a psychiatric evaluation. The doctor will assess the person's:
Given there is no cure for the disease, and treatment at best only slows symptoms for 12 months, you may wonder, why go to all this trouble to diagnose Alzheimer's? There are several reasons:
Yes, although health professionals do not currently recommend using genetic tests. Scientists have discovered certain genes associated with Alzheimer’s (see causes of Alzheimer’s). Risk genes, are genes that raise your risk of developing the disease, but do not guarantee it. While there is a blood test for APOE-e4 (the strongest risk gene associated with Alzheimer’s), even if you test positive it does not mean you have the disease nor that you will develop it. Furthermore, people without risk genes can still develop the disease. A 'clean' test may provide false reassurance.
Next: Treatment for Alzheimer's.
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