When is forgetfulness a normal part of aging, and when is it something more serious? If you are older and have noticeable changes to your memory, you may be concerned about Alzheimer’s disease. Alzheimer’s disease is a serious brain disorder that affects thinking and memory skills as well as the ability to complete daily activities and to care for yourself.
If you are concerned, the first step is to talk to your family doctor. They will complete a full assessment of your health and cognitive abilities to determine if your symptoms are a normal part of aging or the start of Alzheimer’s disease.
Diagnosing Alzheimer’s disease is a multi-step process. Here’s a guide for what you can expect.
How Alzheimer’s disease is diagnosed
Speak to your doctor, clearly state your concerns, and describe your symptoms
For example, you may say, “I’ve noticed changes in my memory and thinking. I’m concerned this might be an early sign of Alzheimer’s disease.” Be as specific as possible to give your physician a clear understanding of your concerns.
Explore possible causes
Your doctor can help rule out other, reversible causes and discuss risk factors. Your provider may ask about:
- Lifestyle: Factors such as stress, depression, sleep quality, and alcohol use that could affect your memory. Certain sexually transmitted infections (STIs) such as tertiary syphilis or other chronic infections can mimic Alzheimer’s disease, so it’s worth mentioning a sexual history or history of any infections.
- Health conditions: Your doctor will perform a physical exam and ask you about existing health conditions or injuries that could provide clues. This might include a routine blood test to check for vitamin deficiencies or thyroid levels, both of which can impact brain function. Your doctor may also explore other brain-related conditions such as stroke, Parkinson’s disease, or a traumatic brain injury (TBI).
- Medications: Be prepared to give your doctor a complete list of all the prescription and over-the-counter medicines you are taking.
- Genetics: Your doctor will ask you about any relatives with dementia and any other health information that could help your provider understand potential risks.
- Other circumstances: Researchers have determined that certain things can raise the risk of an Alzheimer’s disease diagnosis. These include hearing loss and depression. There are treatments for both these conditions. Be sure to talk to your doctor about these important treatments.
Discuss screening options and cognitive assessments
Your doctor may perform a brief in-office test that includes questions and tasks to evaluate memory, attention, and language abilities. Your doctor may refer you to a doctor who specializes in caring for older adults or a neurologist who specializes in treating diseases of the brain and nervous system.
Explore blood biomarkers
Your doctor may recommend a blood test to detect certain Alzheimer’s biomarkers (substances in the body that can be measured to help diagnose or predict a disease). This quick and minimally invasive test may be ordered based on symptoms or to better understand your likelihood of Alzheimer’s dementia.
Discuss imaging
Brain imaging tests such as an MRI (a noninvasive scan that uses magnetic waves), CT scan (a noninvasive scan that combines x-rays and computer imaging), or PET (positron emission tomography) which can be useful to check for changes in your brain structure.
Your doctor may repeat these tests to give them updated information about how your memory and other cognitive functions are changing over time. This also gives your doctor important information about how well treatments are working.
Treatment options for Alzheimer’s disease
If the diagnosis is Alzheimer’s, beginning treatment as early as possible may help preserve daily functioning for a while. An early diagnosis also helps families plan. They can take care of financial and legal matters, address potential safety issues, learn about living arrangements, and develop support networks.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or studies that test possible new treatments for Alzheimer’s. Several Food and Drug Administration (FDA)-approved drugs currently exist to slow the disease or to address specific symptoms.
Some of these drugs change the underlying biology of Alzheimer’s and slow cognitive and functional decline in some individuals. Some have been approved to treat the symptoms of Alzheimer’s dementia.
Drug treatments to slow Alzheimer’s disease
Your doctor can tell you about current drugs that change the underlying biology of the disease. Some drugs have side effects, so be sure to talk to your doctor about those. Researchers continue to explore and develop new drugs and test them in clinical trials. It’s important to speak with your doctor about available clinical trials that might benefit you.
Current approaches to managing cognitive and behavioral symptoms
The FDA has approved some drugs to treat the symptoms of Alzheimer’s disease. These symptoms include cognitive difficulties, agitation, and insomnia. The drugs do not change the underlying brain changes that cause Alzheimer’s, nor do they slow or stop the course of the disease. Instead, they treat symptoms by increasing the amount of chemicals (called neurotransmitters) in the brain. Neurotransmitters help brain cells communicate with each other.
Treatments can change over time, that’s why it’s important to see your doctor regularly and report any changes in your symptoms or disease progression. Caregivers and loved ones can help by keeping a journal of your symptoms and changes over time.
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This article was contributed by familydoctor.org editorial staff.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
