Diagnosing Alzheimer’s or Dementia

Michael knew his mom Louise wasn’t doing as well as she used to. She was still living independently in an apartment a couple hours drive away from him, but she wasn’t going out and would sometimes say or do things that were out of character. Michael took Louise to a series of medical appointments and at one the doctor administered a cognitive test. Louise had to answer a series of questions to check her memory and reasoning skills. The doctor asked Louise to draw a clock and mark the hands at ten minutes after two. She couldn’t do it. Michael was shocked.

There are often signs that things aren’t quite right and it can be frightening to look for answers. Sometimes, there are health issues that cause symptoms similar to those of dementia. It may be possible to treat these with medications or even physical therapy. So, it is important to seek medical support to assess your health and determine the best course of action.

Your primary care physician may be able to complete the assessment or they may refer you to a specialist, such as a geriatrician, neurologist, or psychiatrist.

How is Dementia or Alzheimer’s Diagnosed?

The doctor assessing the patient will likely begin with a physical exam. They will also ask questions about:

• Family history
• When symptoms started
• Personality changes
• Other medical problems
• Medications

It will also be helpful if the doctor can speak with someone close to the patient, such as a friend or family member. They may have observations that go beyond what their loved one has noticed. If the health problem is dementia, it is possible that memory problems may make recall of health or behavioral changes difficult.

Tests for Dementia and Alzheimer’s

There is no single test that provides a clear answer. It will likely be necessary for the doctor to complete a series of tests. These include:

Cognitive Tests

These tests assess memory, reasoning, and language skills. There are a variety of standard tests used, including the MoCA (Montreal Cognitive Assessment), the MMSE (The Mini-Mental State Examination), or the BIMS (Brief Interview for Mental Status), amongst others.

The tests have traditionally been done with a paper and pencil, but may now be conducted on a computer, which can provide more detailed information such as speed of response.

Neurological Tests

These tests will assess balance, reflexes, eye movements, and how the senses work. This type of assessment is conducted throughout life and will likely have been experienced before during routine physical examinations.

Lab Tests

Blood work can show if there is a thyroid problem or a vitamin deficiency. These could impact how the brain works.

Brain Scans

The doctor may use a scan, such as an MRI (magnetic resonance imaging), CT (computerized tomography) scan or PET (position emission tomography) scan, to look at your brain. These can provide information about how the brain is working or if there are other problems, such as bleeding, a stroke, or a tumor.

Psychiatric Evaluation

Depression and other mental health conditions may cause symptoms that mimic those of dementia. An assessment of mood, sense of well-being, and behaviors may indicate that the condition can be treated with medication.

After Receiving a Diagnosis

When people receive a diagnosis of dementia or Alzheimer’s, they often experience strong emotions. They may be frightened, shocked, and upset. People often feel alone. It is important to take some time to process the diagnosis while also connecting with support systems.

Health networks in your city or region include resources for dementia support. These specialized organizations can provide information and educational programs. They also run peer support groups for both individuals with dementia and Alzheimer’s and their caregivers.

Initially, Michael turned to the Dementia Society because he needed support as a caregiver. Louise was able to connect with others struggling with Alzheimer’s. These groups provided much needed social support, but they also helped dispel myths about the illness and gave them hope. Through the educational programs, they were able to learn about dementia, how the brain changes and what they could do to maintain a high quality of life for Louise. She had always said, “Knowledge is power.” With this new power, they would move forward with hope and confidence.