|
Alzheimer's disease is the leading cause of
dementia - a set of symptoms that includes loss of memory, judgment and
reasoning, difficulty with day to day function and changes in mood and
behaviour. If you have noticed these symptoms in yourself, or in someone close
to you, it is important to visit your family doctor for a thorough assessment to
find the cause.
Some of the conditions that cause
dementia, that may be treatable, include depression, thyroid or heart disease,
infections, drug interactions, alcohol abuse, not enough to drink.
Why Find Out?
Finding out the causes of the symptoms can help individuals understand the
source of the symptoms, get the proper care, treatment and support, and plan for
the future.
Making The Diagnosis
There is currently no single test that can tell if a person has Alzheimer's
disease. The diagnosis is made through a systematic assessment which
eliminates other possible causes. Until the time when there is a conclusive
test, doctors will continue to use the words "probable Alzheimer's disease." Don't let these words fool you; doctors making this diagnosis are
accurate 80 to 90 percent of the time.
Making the diagnosis can take time. The diagnosis can be made in a family
doctor's office, a memory clinic, a hospital or in the community. The doctor may
or may not feel that the person needs to see a number of health care
professionals to help make the diagnosis. These may include a psychologist,
psychiatrist, neurologist, geriatrician, nurse, social worker or occupational
therapist. They will look for problems with the person's memory, reasoning
ability, language and judgment, and how these affect day-to-day function.
The process involves...
Medical History: Both the individual
and family members or friends will be asked questions regarding the person's
symptoms now and in the past. There will be questions about past illnesses and
about family medical and psychiatric history.
Mental Status Exam: This part of the
process tests the person's sense of time and place as well as the ability to
remember, express him/herself and do simple calculations. It may involve
exercises such as recalling words and objects, drawing and spelling, and
questions such as "What year is it?"
Physical Exam: To help rule out other
causes, a physical exam will be done. The doctor will look for heart, lung,
liver, kidney or thyroid problems that may be causing the symptoms. To evaluate
whether other nervous system disorders are causing the symptoms, the doctor will
test muscle tone and strength, co-ordination, eye movement, speech and
sensation.
Laboratory Tests: A number of tests
will be done. Detailed blood work will be ordered to help detect problems such
as anemia, diabetes, thyroid problems or infection that might be causing the
symptoms.
Other tests such as X-rays and EEG's
(electroencephalogram) may be used to determine the source of the problem. In
some centres, scans may be used. These may be recommended, but are not always
necessary for a diagnosis:
CT (computerized tomography) scan and MRI (magnetic resonance
imaging) take images of the brain. SPECT (single proton emission
computed tomography) shows how blood is circulating to the brain. PET (positive
electron tomography) shows how the different areas of the brain respond during
certain activities such as reading and talking.
Psychiatric and Psychological Evaluations:
A psychiatric evaluation may be helpful in ruling out other illnesses such as
depression which can cause memory loss similar to Alzheimer's disease. Neuro-psychological
testing can evaluate memory, reasoning, writing, etc.
Preparing for the
Assessment
On the day of the appointment, it will be useful to have the following
information on hand. Writing this information down ahead of time can be helpful.
Things you will be asked:
•What symptoms have been noticed?
•When did they first appear?
•How have the symptoms changed over time?
•What other medical conditions does the person have?
•What medications are currently being taken (both prescription and
over-the-counter)?
•Is there a family history of Alzheimer's disease, "senility",
"hardening of the arteries", neurologic or psychiatric conditions?
Things you may want to ask:
•Which tests will be performed? What is involved in the tests?
•How long will the tests take?
•How long will it take to learn the results?
•How do we learn the results? Who will be involved?
The Family's Role
Sometimes the person experiencing the problems will go to see his or her doctor.
For others, the family will play a role in alerting the doctor of a problem if
the person is reluctant to seek help.
Tips to Lend a Hand:
~make the appointment for the person
~help with transportation
~share this information with other family members
~offer to accompany the person to appointments and tests
~help prepare information for the first appointment
~appreciate that this can be an unsettling time for the person and provide
emotional support
~have patience; it can take a long period of time to arrive at a diagnosis
If the diagnosis is Alzheimer's
disease...
You may want to ask:
~what does the diagnosis mean?
~what can be expected over time?
~what care will be needed and is available, now and in the future?
~what treatment is available? what are the risks and benefits?
~what resources are available in the community to help?
~are there any experimental drug trials to participate in?
| 
