The onset of Alzheimer’s disease is slow and progressive and often the disease has progressed beyond the first stage before the symptoms are recognised and presented to the physician for the formulation of a diagnosis.
However, an experienced physician undertaking a series of tests can work-up a diagnosis that is 90% accurate by simply asking the right questions. There are numerous tests that can be undertaken, however modern technology, specially designed to detect changes in the brain has been developed and are improving all the time, making diagnosis simpler. The imaging is able to detect ‘Tangles’ and ‘Plaques’ in the brain to assist the physician to bring about a conclusive diagnosis of the disease.
Apart from the imaging the following test will be undertaken.
1. A full medical history: Including information on head injuries which might account for the memory loss or poor concentration.
2. Heart disease which could cause restricted blood flow to the brain
3. Any surgical operations which might have caused an adverse reaction to the anaesthetic.
4. History of current medication: To ascertain whether any confusion might be caused by the possible side-effects of prescribed medication.
5. Mood swings: An assessment of the mental state to ascertain the presence of depression or anxiety which might be a root cause of some of the symptoms.
6. Mental Examination: Is undertaken primarily to assess concentration, memory, and any other cognitive skills. This includes a set of questions which have been thoroughly and scientifically researched. The score from the test is able to give a credible indication regarding the presence of the disease, the higher the score the less likely the disease is present.
7. Full physical examination: This is to assess hearing, vision, blood pressure, temperature, pulse and respiration all of which will be measured and assessed in an effort to to eliminate the possibility of any infection which might be exhibiting Alzheimer’s-like symptoms such as confusion.
8. Laboratory tests: Blood and urine tests are undertaken.
9. Neurological tests: To examine motor skills such as reflexs, gait (ability to walk) and hand eye coordination to detect any problems with the nervous system.
10. Last but not least, imagining: This is where detailed pictures of the brain is taken to detect changes in the size and structure of the brain. The tests are also able to reveal any other abnormality such as blood clots, strokes or hydrocephalus.
a. Magnetic Resonance Imagine (MRI) scan
b. Computer Tomography CT (Scan)
c. Position Emission Tomography (PET) Scan
The sole purpose of these examinations is to determine possible cause for the Alzheimer’s-like symptoms and where reversible and treatable problems are present, these should be corrected. However, where the disease is diagnosed then the physician’s duty is to inform, advise and assist the patient and their relatives to develope ways in which the symptoms can be effectively managed with medication, through behaviour management programmes and any other support systems that is available within the community.