Diagnosis of Alzheimer's Disease

 

Diagnosis of Alzheimer's

The diagnosis of Alzheimer's disease is based on several investigations, as there is still no specific test for detecting the disease.

 

To diagnose Alzheimer's disease, the skills of various specialists are essential, including the psychiatrist, the neurologist, and the geriatrician; furthermore, the testimonies of the relatives of the patient are important, as they compensate for the patient's difficulties in exhibiting the symptoms and ailments that concern him.

 

The diagnosis of Alzheimer's also includes an approach by exclusion: it is the so-called differential diagnosis, which involves examinations and tests aimed at ruling out the possibility that the present manifestations are due to other pathologies with similar symptoms.

 

It should be noted that some scientific literature sites are keen to clarify, about the Alzheimer's topic, that only the post-mortem autopsy examination on the brain of the presumed patient and the detection of amyloid plaques and tau protein clusters confirm the presence of the pathology.

Tests to Diagnosis Alzheimer's Disease

Generally, the diagnosis of Alzheimer's is based on information from:

 

Anamnesis;

Physical examination;

Neurological examination;

Cognitive and neuropsychological test;

Laboratory tests ;

Brain imaging tests.

Anamnesis

Also known as clinical history, anamnesis is the acquisition, from the direct voice of the patient and/or his family, of all the information useful to explain certain symptomatology.

 

The medical history typically includes questions regarding the patient's general health, habits, lifestyle, drug therapies followed, any past pathologies, the medical history of his family, etc.

 

In the diagnosis of Alzheimer's, the anamnesis is important because it allows us to understand if the present symptomatology is attributable to the dementia in question.

 

Physical examination for Alzheimer's Disease

 

Physical examination (or physical examination ) consists of a medical assessment of the patient's general health.

 

It provides for diagnostic maneuvers that are used by the doctor to ascertain the presence or absence of signs indicative of some pathological condition.

 

Physical examination is a necessary step in the diagnosis of any disease, including Alzheimer's disease, although in itself it is not sufficient to draw firm conclusions.

 

Neurological examination for Alzheimer's Disease

 

The neurological exam evaluates tendon reflexes, motor skills (eg balance, coordination, etc.), and sensory functions.

 

In the diagnosis of Alzheimer's, the neurological examination can be considered as a more specific physical examination, which serves to deepen the information relating to the patient's state of health.

Cognitive and Neuropsychological Test

The cognitive and neuropsychological examination tests the patient on various fronts and skills, such as:

 

Memory;

Caution;

Problem-solving skills ;

Language and communication skills;

Reasoning and calculation skills;

Behavioral and psychiatric function.

The cognitive and neuropsychological examination can provide very useful diagnostic information, sometimes decisive for the confirmation of the pathology; however, it is good to specify the importance of performing it always taking into account some aspects of the patient, such as the level of education and general physical health (hearing level, sight capacity, etc.), which could distort the outcome of the assessment (a low level of education could be mistaken for a memory problem or impaired calculation ability).

 

The cognitive test is used for diagnostic purposes and to evaluate the progression and severity of Alzheimer's.

 

Alzheimer's Diagnosis: the Mini-Mental Test

A cognitive test particularly suitable for diagnosing Alzheimer's is the Mini-Mental Test, also known as the Mini-Mental State Examination or Folstein Test.

The Mini-Mental Test is a questionnaire consisting of 30 questions, which allow you to analyze the skills of calculation, memory, reasoning, language, attention, etc. of the person.

 

The Mini-Mental State Examination is useful in diagnosing all dementias, not just Alzheimer's disease.

 

Laboratory exams of Alzheimer's Disease

The diagnostician wants to analyze a series of parameters through specific laboratory tests, blood but not limited to, whose alteration is typically associated with symptoms that can resemble those of Alzheimer's disease.

 

Laboratory tests, therefore, are used in a differential diagnosis perspective: they exclude pathologies and conditions characterized by manifestations superimposed on Alzheimer's and could be mistaken for the latter.

 

Laboratory tests useful for the diagnosis of Alzheimer's include:

 

Blood sugar ;

Blood measurement of vitamin B12 ;

Urinalysis ;

Toxicological test (allows you to understand whether or not the symptoms are attributable to the intake of some drug or other toxic substance);

Blood measurement of thyroid hormones.

Diagnostic Imaging: CT and MRI of the Brain

Brain CT and MRI of the brain provide detailed, three-dimensional images of the brain organ.

 

Like laboratory tests, CT and magnetic resonance imaging are used for a differential diagnosis: they are no specific tests for Alzheimer's, but they can identify brain pathologies, such as strokes, tumors, vascular anomalies, etc., which produce symptoms similar to aforementioned dementia.

 

Therefore, the diagnostic imaging based on CT and magnetic resonance includes procedures useful for the exclusion of pathologies characterized by manifestations similar to Alzheimer's.

 

PET (Positron Emission Tomography) in Alzheimer's Diagnosis

Some variants of PET (positron emission tomography) allow the identification of amyloid plaques, neurofibrillary tangles of tau protein, and other signs of brain degeneration typical of Alzheimer's. However, it should be noted that these procedures are used in the field of research and clinical study of the disease, and not in the normal diagnosis.

 

Differential diagnosis

Diseases and Conditions that Cause Alzheimer's-like Symptoms

As part of the detection of Alzheimer's disease, the differential diagnosis aims mainly to exclude:

 

Stroke;

Parkinson's disease ;

Sleep disturbances ;

Adverse effects of drugs or toxic substances;

Cognitive decline related to old age ;

Dementias are other than Alzheimer's (e.g. vascular dementia, Lewy body dementia, etc.).

Early diagnosis
Importance of Early Diagnosis in Alzheimer's

An early diagnosis of Alzheimer's allows you to implement all the appropriate therapies in the early stages of the disease.

 

Although Alzheimer's disease is a progressive neurodegenerative disease, its early symptomatic treatment helps to maintain cognitive functions longer, somewhat slowing the course of the disease.