July 29, 2010
Diagnosing Alzheimer’s will likely involve several types of evaluations and may take more than one day. In many cases, specialists may be seen, such as a neurologist, psychologist or psychiatrist, in addition to your primary care doctor, as they may have the knowledge and training needed to evaluate symptoms correctly, accurately, and efficiently.
Evaluations commonly performed include:
Medical history: an interview or questionnaire to identify past medical problems, difficulties in daily activities and any medications (prescriptions, vitamins, supplements and over-the-counter medications), among other things. It is important to inform the doctor of any family history of Alzheimer’s or other related medical issues. The doctor may wish to speak to a close family member to supplement information, as it is important to get a thorough picture of a person’s medical history.
Physical examination: should include evaluations of hearing and sight, heart and lungs, as well as temperature, blood pressure and pulse readings. The doctor might also ask about diet and nutrition and use of alcohol and tobacco products.
Standard laboratory tests: might include blood and urine tests designed to help eliminate other possible conditions. These will measure things like blood count, thyroid and liver function, and levels of glucose and other blood-based indicators of illness. A depression screening should also be conducted. In some cases, a small sample of spinal fluid may be collected for testing.
Neuropsychological testing: Doctors use a variety of tools to assess memory, problem-solving, attention, vision-motor coordination and abstract thinking, such as performing simple calculations in your head. The goal is to better characterize the types of cognitive symptoms present, which might provide clues to the underlying cause. The most commonly used test is called a mini-mental state exam, or MMSE. During the MMSE, the doctor or health professional will ask a number of questions which test a variety of common mental skills. Some examples of questions on the MMSE will ask about the date or the person’s location and also ask the person to count backward or copy a drawn figure.
Brain-imaging scan: MRI and CT scans look at the structure of the brain and are used to rule out brain tumors or blood clots in the brain as the reason for symptoms. PET scans can look at how certain parts of the brain are working or how active they are. Many scientists are trying to determine if other brain-imaging techniques might be able to identify telltale signs of early Alzheimer’s reliably enough to be used as diagnostic tools.