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Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
What lab tests do you use?
The primary role of lab tests — usually with blood samples — is to rule out other disorders that can cause some symptoms similar to those of Alzheimer's disease, such as a thyroid disorder or vitamin B-12 deficiency.
What is the current role of brain-imaging tests?
Alzheimer's disease results from the progressive loss, or degeneration, of brain cells. This degeneration can show up in a variety of ways in brain scans. But these scans alone aren't enough to make a diagnosis. This is because there's a lot of overlap in what we consider normal age-related change in the brain and abnormal change.
But brain imaging can help:
- Rule out other causes, such as hemorrhages, brain tumors or strokes
- Distinguish between different types of degenerative brain disease
- Establish a baseline about the degree of degeneration
The brain-imaging technologies most often used are:
- Computerized tomography (CT), which is a specialized X-ray technology that produces thin cross-sectional images of the brain
- Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to create either cross-sectional or 3-D images of the brain
What does the future of diagnosis look like?
Researchers are working on new diagnostic tools that may enable us to diagnose Alzheimer's disease earlier in the course of the disease, when symptoms are very mild or before symptoms appear. Scientists are investigating a number of disease markers — genes, disease-related proteins and imaging procedures — that may accurately and reliably indicate whether someone has Alzheimer's disease and how much the disease has progressed. However, more research on these tests is necessary.
What's the benefit of an early diagnosis?
Reluctance to go to the doctor when you or a family member has memory problems is understandable. People hide their symptoms, or family members cover for them. That's easy to understand because Alzheimer's is such a dreaded disease. And many people wonder if there's any point in a diagnosis if there's no cure for the disease.
It's true that if a person has Alzheimer's or a related disease, we can't offer a cure. But getting an early diagnosis can be beneficial. If a person has another treatable condition that's causing the cognitive impairment or somehow complicating the impairment, then we can start treatments.
And for those with Alzheimer's disease, we can offer drug and nondrug interventions that may ease the burden of the disease. We usually prescribe drugs that may slow the decline in memory and other cognitive skills. Also, we can educate caregivers and a person with Alzheimer's about strategies to enhance the living environment, establish routines, plan activities and manage changes in skills in order to minimize the effect of the disease on everyday life.
Importantly, an early diagnosis also helps a person with Alzheimer's disease, family and caregivers plan for the future. They have the chance to make informed decisions on a number of issues, such as:
- Appropriate community services and resources
- Options for residential and at-home care
- Plans for handling financial issues
- Expectations for future care and medical decisions
When we tell a person and family members about an Alzheimer's diagnosis, we help them understand that Alzheimer's is not an all-or-nothing phenomenon. We talk about what capacities are preserved and look to keep a person as healthy and safe as possible.Previous page
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- Tangalos EG (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 14, 2010.
- 10 signs of Alzheimer's. Alzheimer's Association. http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp?type=more_information. Accessed Sept. 11, 2010.
- Grabowski TJ. Clinical manifestations and diagnosis of Alzheimer disease. http://www.uptodate.com/home/index.html. Accessed Sept. 8, 2010.
- Cummings JL, et al. Guidelines for managing Alzheimer's disease: Part I. Assessment. American Family Physician. 2002;65:2263.
- Hort J, et al. EFNS guidelines for the diagnosis and management of Alzheimer's disease. European Journal of Neurology. 2010;17:1468.
- Knopman DS, et al. Practice parameter: Diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1143.