Complications (1)
- Alzheimer's: Managing sleep problems
Definition (1)
- Early-onset Alzheimer's: When symptoms begin before 65
Risk factors (2)
- Alzheimer's: Is it in your genes?
- Diabetes and Alzheimer's linked
Symptoms (3)
- Alzheimer's stages: How the disease progresses
- Memory loss: When to seek help
- Alzheimer's or depression: Could it be both?
Tests and diagnosis (3)
- Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
- SPECT scan
- Positron emission tomography (PET) 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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continued:
Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
What other types of tests are helpful?
A two- to four-hour battery of neuropsychological tests is a routine part of our Alzheimer's research at Mayo Clinic. We compare skill levels of people who may have Alzheimer's with those of people at the same age and education level. We know that an 85-year-old is not going to function as well as a 75-year-old. These tests show us exactly what people can and cannot do based on comparisons to standard tests of people with the same sex, education and age.
From these studies and knowing what support they have at home, we can tell if the person can still function independently or if he or she is really on the edge and should be looking for a safer living environment. Alzheimer's is not an all or nothing phenomenon, so this is why we always talk about what capacities are preserved and what capabilities may be lost.
What's the benefit of an early diagnosis?
There are both drug and nondrug interventions. Drug therapy isn't a magic bullet, but it can delay or slow the progress of the disease. Alzheimer's drugs help some people more than others, but in general, you end up better on the drugs than not on them. With this disease right now, "better" is just not getting worse.
And an early diagnosis isn't just about starting drug therapy. You can change your home environment and simplify the world around you. The sooner you move into a structured environment, the more protected you'll be. The ideal setting is probably one that includes independent housing, assisted living and nursing services on the same campus. The same philosophy is at play throughout, so there's less to learn with each move.
What else can be done?
People with Alzheimer's do better when they have a routine to follow. It allows them to refresh and reinforce their pattern of behavior every day. They get to relearn their habits over and over and this is good.
When you put them in strange surroundings, they don't do well. That's why they may have trouble when you bring them to your house for the holidays, or if they have to be hospitalized. A change in routine is not good for people with Alzheimer's — there are just too many problems to try and solve.
The change in routine is one of the reasons why people with Alzheimer's often have such a swift downturn after the death of a spouse. The spouse may have been helping to both think for and protect the person.
What do you hope to see in the future?
I'd like to see people come in earlier for diagnosis. People hide their symptoms, or spouses cover for them. That's easy to understand because Alzheimer's is such a dreaded disease. But just because you have a memory problem doesn't mean you can't drive a car. We look for what you have retained and do our best to keep you as healthy and safe as possible with as little opportunity to fail.
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- 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.
