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  Prevention Through Delay

Symptoms and Progression

Early Detection

>Diagnosis

Treatment

  Having memory loss or cognitive impairment does not mean that you have Alzheimer's Disease (AD). Through a standard medical evaluation and diagnostic protocol, physicians often find that depression, a metabolic disorder, or other medications are impairing a patient's memory. By following these guidelines and ruling out other causes of memory loss, physicians can diagnose AD with better than 90% accuracy at an early stage of the progression.

Diagnosing Alzheimer's Disease early and accurately is crucial because for every month that treatment is delayed, there is irreversible loss of function. Current treatment of mildly-to-moderately demented AD persons with FDA-approved medication will delay AD progression by three or more years; the earlier treatment is started the more effectively the progression of AD is blocked, and the longer it is delayed. Below are suggested steps to get the right diagnosis:

  1. Find the Right Physician

  2. For evaluating and treating ADRD, there is no substitute for experience and proper training. Neurologists, psychiatrists, or geriatricians are the specialists most likely to have been trained to evaluate ADRD using the NINDS-ADRDS criteria, and effectively treat the cause. Some internists or primary care physicians have also been properly trained. If you don't know where to start, ask your primary care doctor or look up the local chapter of the Alzheimer's Association by searching on www.alz.org.

  3. Get Tested Professionally

  4. Objective tests of mental abilities are used to confirm cognitive impairment as well as to help diagnose its cause. Of the cognitive functions impaired in Alzheimer's Disease, short-term memory loss is one of the first. Therefore tests of short term memory loss can identify Alzheimer's Disease at its earliest stages. Your physician or a neuropsychologist may be able to conduct such professional testing.

  5. Collect Patient and Family History

  6. The medical and family history is key to a proper diagnosis of ADRD. A proper history includes:

    • All medications, including over the counter medications, along with when they were started
    • Past medical conditions
    • List of all current medical conditions
    • Life style history including head injuries, alcohol, smoking, exercise, diet, hobbies or pastimes
    • Psychosocial history such as marital state, living conditions
    • Family history of memory/cognitive impairment, senility/dementia, AD, ADRD and risk factors for ADRD

  7. Identify Treatable Medical Conditions

  8. Treatable medical conditions that can cause cognitive impairment or dementia include diseases of virtually every organ and tissue of the body, especially the heart, lung, thyroid, kidney, liver, blood vessels and immune system. Psychiatric or neurologic conditions, such as depression, manic-depression, anxiety and stress can also affect memory and other cognitive abilities. These conditions are identified through history and physical examination, plus diagnostic tests of blood, urine, X-rays, and brain imaging.

  9. Brain Imaging Studies

  10. Brain imaging has two primary functions. First, it helps establish how much damage to the brain has occurred. Second, it helps diagnose the underlying cause of the damage. The choice of which brain image to do (CT, MRI, SPECT, PET or fMRI) depends upon the duration and severity of the condition. When MRI or CT scans show no brain tissue loss, imaging of the brain's activity should be done with SPECT, PET or fMRI to detect abnormalities and help make an early diagnosis.

  11. Final Diagnosis

  12. Based on the history, examination, laboratory and brain imaging results, a properly trained physician can diagnose the cause of your condition with 90% accuracy or higher using NINDS-ADRDS criteria. Typically it takes a few weeks to complete a diagnostic evaluation of ADRD.

 

 
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