Alzheimer's Disease
Symptoms and Diagnosis
Forgetfulness and Memory Problems
As people get older, changes occur in all parts of the body, including the brain. As a result, some people may notice that it takes longer to learn new things, they don't remember information as well as they did, or they misplace things like their keys. These usually are signs of mild forgetfulness, not serious memory problems.
Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful. Some health issues, such as medication side effects, vitamin B12 deficiency, chronic alcoholism, and brain tumors, can cause memory loss or even dementia.
Early Symptoms of Alzheimer's
Memory loss that is associated with Alzheimer's disease or dementia is severe enough to interfere with activities of daily living. At first, the only symptom may be mild forgetfulness. People may be unable to remember recent events, ask the same question over and over, and become lost in familiar places. A person may seem healthy but is actually having more and more trouble making sense of the world around him or her. Such difficulties could be due to Alzheimer's disease or another condition. A doctor should be consulted to make a diagnosis.
Alzheimer's disease varies from person to person. Not everyone will have the same symptoms. It can progress faster in some people than in others. In general, though, Alzheimer's takes many years to develop, becoming increasingly severe over time.
As the disease goes on, memory gets worse. People may have problems recognizing family and friends. It can be hard to learn new things. People in this moderate stage of Alzheimer's may behave differently, too. For example, they might be restless, agitated, or angry, or they may wander. As Alzheimer's disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they cannot control their bladder and bowel. Eventually, they need total care.
Why Early Diagnosis Is Important
An early, accurate diagnosis of Alzheimer's disease helps patients and their families plan for the future. It gives them time to discuss care options and make legal and financial arrangements while the patient can still take part in making decisions. And even though no drug can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms.
How Alzheimer's Is Diagnosed
Today, the only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles co-exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, which is an examination of the brain done after a person dies.
Doctors can only make a diagnosis of "possible" or "probable" Alzheimer's disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. These include board-certified geriatricians, geriatric psychiatrists, and neurologists. (A geriatrician specializes in treatment of older adults, and a neurologist specializes in brain and nervous system disorders.)
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Diagnostic Tools
Doctors use several tools to diagnose Alzheimer's disease.
- a complete medical history with questions about the person's general health, past medical problems, family health, and any difficulties carrying out daily activities
- medical tests, such as tests of blood, urine or spinal fluid
- tests to measure memory, problem solving, attention, counting, and language skills
- brain scans that allow the doctor to look at a picture of the brain to see if anything does not look normal
Sometimes, test results help doctors to rule in or rule out other possible causes of the person's symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood-vessel disease in the brain can cause symptoms similar to those of Alzheimer's. Some of these other conditions can be treated successfully.
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Researching New Diagnostic Approaches
Researchers are exploring new ways to help doctors diagnose Alzheimer's disease earlier and more accurately. Some studies focus on changes in a person's memory, language, and other mental functions. Others look at changes in blood and spinal fluid that may detect Alzheimer's years before symptoms appear.
Another area of research is neuroimaging or brain imaging. Scans that measure the earliest changes in brain function or structure may one day help identify people in the very first stages of Alzheimer's disease -- long before symptoms begin.
