Complications (1)
- Alzheimer's: Managing sleep problems
Definition (1)
- Early-onset Alzheimer's: When symptoms begin before 65
Risk factors (2)
- Diabetes and Alzheimer's linked
- Alzheimer's: Is it in your genes?
Symptoms (3)
- Alzheimer's or depression: Could it be both?
- Memory loss: When to seek help
- Alzheimer's stages: How the disease progresses
Tests and diagnosis (3)
- Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
- Positron emission tomography (PET) scan
- SPECT scan
Treatments and drugs (3)
- Alzheimer's: Getting the most from medical appointments
- Alzheimer's drugs slow progression of disease
- Alzheimer's treatments: What's on the horizon?
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Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
To diagnose Alzheimer's disease, doctors rule out several other conditions and recommend psychological testing. It's tough but worth the effort, says a Mayo Clinic specialist.
By Mayo Clinic staff
In this interview, Eric Tangalos, M.D., a primary care physician and co-director for education at the Alzheimer's Disease Research Center at Mayo Clinic, Rochester, Minn., explains why older people with memory problems should have a thorough diagnostic workup. If fears are confirmed, information and planning can smooth the path for the ensuing years.
How can people recognize the early signs of Alzheimer's?
In the earliest stage of the disease, a diagnosis can be really difficult. What you're looking for is something that doesn't fit with the individual's former level of function. That's why family members often notice the symptoms first. The disease affects more than just memory — it can involve language, problem solving or even how we draw a clock.
It's easy to misplace your car in the parking lot. That's happened to all of us. But most of us eventually find our cars. People with Alzheimer's lose the capacity to adjust and solve the problem of the lost car. In fact, they might jump to the conclusion that the car has been stolen.
Alzheimer's is a progressive disease that first manifests itself with problems usually related to memory. Over time, people have more difficulty with tasks. By the end of the disease process, Alzheimer's is pretty easy to recognize. Our goal is to find out from family as quickly as possible when something is truly amiss in order to do something about it.
What are the warning signs of Alzheimer's disease?
The Alzheimer's Association's 10 warning signs are:
- Memory loss
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
Can magnetic resonance imaging (MRI) or computerized tomography (CT) scans help in diagnosing Alzheimer's?
There's no biological marker at this time specific enough to prove that someone has the disease. The brain typically changes with Alzheimer's, and those changes can show up in a variety of characteristic ways. But that's not enough to make a diagnosis. There's a lot of overlap in what we consider normal and abnormal, so even if some areas change on CT or MRI, the person may still function quite well.
In our research, we use brain changes on MRI to help us assess the possibility of Alzheimer's. In most clinical settings, brain imaging should be used only to rule out such things as hemorrhages, brain tumors or strokes. However, we are getting closer and closer to defining Alzheimer's with both laboratory and imaging tests.
What other diseases should be ruled out?
We'd want to check the thyroid, to rule out problems there. And, in many cases, the symptoms of depression can be mistaken for Alzheimer's — and vice versa. We also routinely look for vitamin B-12 deficiency and always try to make sure that the person is generally healthy and doesn't have some other serious medical problem that would complicate our diagnosis. A lot of our older patients have other medical problems that just make things worse — like heart disease, high blood pressure, strokes, diabetes, kidney disease, lung disease or any combination of these.
Next page(1 of 2)
- Tangalos EG (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 25, 2008.
- Shadlen MF, et al. Evaluation of cognitive impairment and dementia. http://www.uptodate.com/home/index.html. Accessed Sept. 24, 2008.
- Warning signs of Alzheimer's. Alzheimer's Association. http://www.alz.org/alzheimers_disease_symptoms_of_alzheimers.asp. Accessed Sept. 24, 2008.
- Press D, et al. Cholinesterase inhibitors in the treatment of dementia. http://www.uptodate.com/home/index.html. Accessed Sept. 24, 2008.
- Press D, et al. Treatment of behavioral symptoms related to dementia. http://www.uptodate.com/home/index.html. Accessed Sept. 24, 2008.
