How is Alzheimer’s disease diagnosed?
Doctors use several methods and tools to help determine whether a person who is having memory problems has “possible Alzheimer’s disease” (dementia may be due to another cause), “probable Alzheimer’s disease” (no other cause for dementia be found), or some other problem.
To diagnose Alzheimer’s, doctors may:
- Ask the person and a family member or friend questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality
- Conduct tests of memory, problem solving, attention, counting, and language
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem
- Perform brain scans, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the person’s memory and other cognitive functions are changing over time. Tests can also help diagnose other causes of memory problems, such as mild cognitive impairment and vascular dementia. Alzheimer’s disease can be definitely diagnosed only after death, by linking clinical measures with an examination of brain tissue in an autopsy.
For more information, download this free booklet: Understanding Memory Loss.
What are options for further assessment and diagnosis?
If a primary care doctor suspects mild cognitive impairment or possible Alzheimer’s, they may refer you to a specialist who can provide a detailed diagnosis, or you may decide to go to a specialist for further assessment. Specialists include:
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
- Neuropsychologists, who can conduct tests of memory and thinking.
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You may also want to get a second opinion. Diagnosis of memory and thinking problems can be challenging. Subtle signs and symptoms may be overlooked or unclear. Getting a second opinion helps confirm the diagnosis. Most doctors understand the benefit of a second opinion and will share your records if you permit. A specialist can refer you to another doctor for a second opinion, or you may decide to find one yourself.
What are the benefits of early diagnosis?
Early, accurate diagnosis is beneficial for several reasons. While there is still no effective treatment or cure for Alzheimer’s, there are some medication options that can help slow the progress of the disease.
Having an early diagnosis helps people living with Alzheimer’s:
- Plan for the future
- Take care of financial and legal matters
- Address potential safety issues
- Learn about living arrangements
- Develop support networks
In addition, an early diagnosis gives people greater opportunities to participate in clinical trials that are testing possible new treatments for Alzheimer’s disease and other research studies.
Can Alzheimer’s disease be treated?
While there are some medications prescribed to people living with Alzheimer’s disease, there is still no way to cure or reverse it. Current approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow or delay the symptoms of disease.
Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimer’s. Donepezil (Aricept®), rivastigmine (Exelon®), and galantamine (Razadyne®) are used to treat mild to moderate Alzheimer’s (donepezil can be used for severe Alzheimer’s as well). Memantine (Namenda®), is used to treat moderate to severe Alzheimer’s.
These drugs work by regulating neurotransmitters, the brain chemicals that transmit messages between neurons. They may help maintain thinking, memory, and communication skills and help with certain behavioral problems. However, these drugs don’t change the underlying disease process. They are effective for some but not all people and may help only for a limited time.
No published study directly compares the four approved drugs. Because they work in a similar way, it is not expected that switching from one of these drugs to another will produce significantly different results. However, someone may respond better to one drug than another.