Tuesday, 15 May 2018 00:00

Understanding medical tests for determining Alzheimer’s

When a person is alive and suffering from Alzheimer’s disease, there is actually no way to know for certain it is, in fact Alzheimer’s. Only once that person has passed, can an official diagnosis of Alzheimer’s be made during a full autopsy.

Unfortunately, the exact science of diagnosing both Alzheimer’s and dementia has not yet been determined. However, there are numerous tests which have been developed over time that can assist in determining the cause of a person’s memory and behavioural changes – which may be consistent with other cases of Alzheimer’s.

Tests can identify but not diagnose

The tests are actually designed to rule-out other causes of brain, memory and behavioural function which can be triggered by other diseases. This way, doctors are approximately 80% accurate in identifying Alzheimer’s as the cause of mental and behavioural changes in patients.

What’s important to remember is that not one case of Alzheimer’s is the same as the next, hence the difficulty in pinning down an exact diagnosis. This goes on to prove that science, or life in general, is not always black and white – but an entire spectrum of colour which must be navigated with empathy and understanding.

Despite this, a battery of tests have been developed over the years to help determine the onset of Alzheimer’s disease and the necessary treatment thereafter. Just some of these diagnostic tools include:

1. Medical history testing

When testing for most diseases, a medical history of the patient and their family must be fully understood by a physician or specialist. A patient will be asked what current health issues they have, current medications and if there is any family history of genetic diseases- such as Alzheimer’s or dementia.

2. Physical examination

This is where a patient will undergo a physical exam by their primary care physician, including blood or urine testing to rule out other potential conditions which can exhibit similar symptoms to Alzheimer’s. These conditions include vitamin deficiencies, thyroid problems, diabetes, kidney disease or severe reactions to medications.

3. Cognitive examination

Cognitive testing will be done if a diagnosis cannot be determined after the physical and medical examinations are performed. Cognitive performance is tested in two ways: The Mini-Mental State Exam and the Mini-Cog Exam.

The Mini-Mental State Exam consists of memory recall of a short list of instructions and words. If a patient scores lower than 30, this suggests the presence of cognitive decline.

The Mini-Cog tests involves simple word recall and a person’s ability to draw a clock accurately. If they score 4 points or less, further cognitive evaluation is necessary.

4. Neuropsychological examination

This is where the basic neurological function of a person’s brain is tested, including their reflexes, eye movements, speech and co-ordination. This testing is necessary to rule out neurological conditions which can carry similar symptoms to Alzheimer’s, such as brain tumours, fluid on the brain and stroke.

5. Brain imaging

This is probably the most accurate and important form of testing in order to determine whether Alzheimer’s is the cause of memory and behavioural changes. Through an MRI, CT scan and PET scan, physicians can understand the size of a patient’s brain, structure and chemistry.

As we age, our brains tend to shrink an average of 1% each year, however, the brain of an Alzheimer’s patient shrinks by at least 3% each year. This is where MRI and CT imaging can show doctors, for certain, the effect the disease is having on the brain. A PET scan allows doctors an insight into the chemistry of the brain, determining different areas which have been affected, abnormalities in brain tissue and activity and whether areas of the brain are living or dead.

So, when is the best time to take a loved one for testing if you suspect the onset of Alzheimer’s or dementia? Look out for abnormalities in behaviour that seem to happen more and more often, or worsen over time. For example, if a loved one misplaces their belongings, loses track of time or day, can’t remember certain words or struggles with simple directions – these should all be noted as red flags.

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