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Alzheimer's Disease

Testing and Diagnosing of Alzheimer's Disease

08/17/2004

Question:

Are there reliable screening techniques used by gerontologist, or internist that can diagnosis early Alzheimer`s Disease with some level of confidence?

How is "early" diagnosis, with regard to Alzheimer`s Disease, currently described for the patient and family caregiver in terms they can understand? Thank you.

Answer:

A definitive diagnosis of Alzheimer's disease is still only possible after death, during a brain autopsy.  But with the new tools available, experienced physicians are pretty accurate at making the diagnosis in a living person.  Clinicians are about 90% accurate in the diagnosis when studies are done comparing clinical diagnosis with autopsy findings.    There are several screening tools, primarily Q&A tasks that measure memory, language skills, and other abilities related to brain functioning.  The Folstein Mini-Mental Test is one of the most widely used tests.  These screening tools are used in addition to an extensive set of blood and other medical tests, a brain scan, interview with family members/close friends, and a detailed medical and psychosocial history of the individual.  Some physicians will also refer an individual for more in depth neuropsychological testing by a psychologist, which can take several hours.  Screening tests alone are not useful without a detailed physical and medical history, and it is important to recognize that there are many false positives and false negatives with screening tests. 

The early stages of AD are generally explained to individuals and families as the very mild changes in brain functioning characterized by memory loss, confusion about times and dates, taking longer to accomplish normal daily tasks, trouble handling complicated tasks and decisions, and mood and personality changes.   Early diagnosis of AD is encouraged to rule out other existing medical conditions, and to start using medications that help people maintain there memory and thinking abilities at a higher level for a longer time.  It also helps individuals and their families plan for the future and find support networks. With early diagnosis, individuals with AD can still participate in making decisions about the present and future and in improving the quality of their life. 

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Response by:

Paula K Ogrocki, PhD Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University