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How is Alzheimer’s Disease Diagnosed?

by icontrolmyhealth
Alzheimer's Disease

Alzheimer’s Disease:

“He often used to forget his way back home. I had noticed a change in his behavior too. Not recollect my sister’s name easily, and not able to remember my phone number. This was very unusual,” narrates Mr. Keith’s wife. Mr. Keith, now 73 years old, worked as a chief editor for a local newspaper for 34 years. His wife noticed his symptoms at a very early stage. He is now diagnosed to have cognitive impairment. The neurologists suspect he is suffering from AD.

If you are concerned about unusually forgetting things or suffering memory problems, it is advisable that you talk to your Healthcare Provider (HCP). Your HCP may suggest you take a memory-screening test that can help detect problems. You may also need to undergo a complete physical examination, and some laboratory, and brain imaging studies.

1. Medical History

Your HCP may ask you several questions about your overall health, past illnesses, and symptoms that you or those near you have noticed. You must mention the difficulties of forgetting things, performing daily activities, and speech problems if any.

2. Physical Examination

Your HCP may conduct a physical examination and also check your neurological health by testing your ability to get up and walk properly, balance, coordination, hear and see things.

3. Laboratory Tests

There are no specific tests that can confirm the diagnosis of AD. However, blood tests and urine tests may rule out other causes of memory loss.

4. Brain Imaging Studies

Brain imaging studies or scans are used to identify visible abnormalities, such as trauma or tumors that may cause memory problems. You may need to undergo brain scans, such as computed tomography (CT) or magnetic resonance imaging (MRI) to distinguish AD from other possible causes.

If the HCP suspects that you are suffering from AD, you may be advised to see a specialist, who can understand the details of your condition.

The specialists include Alzheimer’s Disease:

1. Geriatricians Alzheimer’s Disease (AD)

Geriatricians are physicians who have expertise in the care of old people. They understand the changes in the aging body and can detect the symptoms accurately.

2. Geriatric Psychiatrists

Geriatric psychiatrists specialize in evaluating mental health problems in old people.

3. Neurologists

Neurologists specialize in abnormalities of the brain and central nervous system. They can evaluate and review the results of brain scans.

4. Neuropsychologists

Neuropsychologists are healthcare professionals who can conduct tests of memory and thinking.

What Does the New Research Say?

Researchers have identified some novel biomarkers that may identify the risk of developing Alzheimer’s Disease (AD)

  • According to the researchers at the Washington University School of Medicine report, the buildup of amyloid plaques (hyperlink) and the protein tau in the brain can identify people who are likely to develop cognitive problems.
  • Some other researchers also found that certain blood-based protein biomarkers such as cortisol, pancreatic polypeptide, insulin-like growth factor binding protein 2, β(2) macroglobulin are increased in individuals with AD.
  • Recently, a novel gene/protein–ALZAS(Alzheimer Associated Protein) has been identified that may become a useful “non-invasive” diagnostic marker via a simple blood test.
  • The scientists believe that in the future reliable biomarkers for AD would be confirmed.

What Does the Diagnostic and Statistical Manual Of Mental Disorders (DSM-5)Say?

The DSM-5 (A manual used by clinicians and researchers to diagnose and classify mental disorders) categorizes AD as Neurocognitive Disorder (NCD). This term was introduced in the revised version of DSM-5 released in May 2013.

This change was implemented to avoid the stigma associated with the term “dementia,” which in Latin means “without mind.” However, it may still be considered as an alternate term due to its familiarity among clinicians and patients. Another major and most distinct change in the DSM-5 is the introduction of categories – mild and major NCD.

These terms are applicable to all neurocognitive disorders, such as AD, Parkinson’s disease, HIV infection, Lewy body disease, and vascular disease. This means that AD can be classified as a major or mild disease, depending on the symptoms.

Mild NCD due to AD, which was earlier known as Mild Cognitive Impairment, is the most bothersome symptom faced by the majority of the elderly population. Although their symptoms do not fit into the diagnostic criteria for a major NCD, it is clearly disturbing.

People suffering from mild NCD can live independently; however, they may have to struggle with some of their daily activities and explain this problem to their healthcare provider. The pathological changes that lead to AD begin much before the symptoms are actually seen.

Therefore, a combination of symptoms of mild NCD and the presence of specific biomarkers significantly increase the likelihood that mild NCD may progress to AD (major NCD). Therefore, DSM-5 has included the term mild NCD so that those people who have a chance of progressing to AD, be diagnosed much earlier.

Diagnostic Criteria for Major NCD Due to Alzheimer’s Disease (AD)

  • Evidence of substantial decline in neurocognitive performance
  • Cognitive impairment that interferes with daily activities making a person less independent
  • A cognitive impairment need not specifically occur in the context of delirium (severe confusion and disorientation)
  • Cognitive impairment that is not attributable to another mental disorder (e.g., major depressive disorder, schizophrenia).

Diagnostic Criteria for Mild NCD Due to Alzheimer’s Disease (AD)

  • Evidence of modest decline in neurocognitive performance
  • Cognitive impairment that does not interfere with daily activities and therefore the person may not be completely dependent on others
  • A cognitive impairment need not specifically occur in the context of delirium (severe confusion and disorientation)
  • Cognitive impairment that is not attributable to another mental disorder (e.g., major depressive disorder, schizophrenia).

Last Reviewed on: August 02, 2014

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