As the most common form of dementia, many people wish to know whether they’re at risk of developing Alzheimer’s as they get older. There is no single test or scan to determine whether someone is living with dementia or Alzheimer’s. Doctors use diagnostic tools, combined with numerous other factors, to form an accurate diagnosis.
Several diagnostic tests can be used when Alzheimer’s risk factors are present. Today, we’ll explore seven of the most common tests and what to expect from each.
1. Physical Examination
One of the most common and first diagnostic tests you’ll be offered is a physical exam, where your doctor will obtain accurate background information and assess your risk factors.
During the exam, your doctor will most likely:
- Ask about your diet, nutrition and use of alcohol
- Review your current and past medications
- Check your blood pressure, temperature and pulse
- Assess heart and lung function
- Perform other procedures to assess your overall health
- Collect a blood and urine sample for further testing
Information learned from these tests can be used to identify health issues that can cause symptoms of dementia. Common causes of dementia-like symptoms can include depression, delirium, medication side effects, thyroid problems and excessive alcohol consumption.
Unlike Alzheimer’s, these symptoms may be reversible with the correct treatment. However, if your doctor diagnoses you with Alzheimer’s or another dementia, you can begin your management planning.
2. Neurological Exam
A neurological exam looks at your brain closely and evaluates any problems that might signal brain disorders other than Alzheimer’s. Your doctor will look for signs of stroke, Parkinson’s disease, brain tumours, buildup of fluid, and other conditions that may impair cognitive function.
Your doctor will most likely test your:
- Reflexes
- Eye movement
- Coordination, muscle strength and tone
- Speech
- Sensation
The neurological exam might also include a brain imaging study. If your evaluation doesn’t indicate Alzheimer’s, your doctor may need to order more tests or get a second opinion.
3. Cognitive, Functional and Behavioural Tests
Cognitive, functional and behavioural tests look into your memory, thinking and problem-solving abilities, often picking up on changes in behaviours and Alzheimer’s symptoms. Certain tests are quick, while others can be more complex.
If your doctor believes you need more comprehensive cognitive tests, they may refer you to a neuropsychologist to evaluate executive functioning, attention, judgment and language.
These tests give your healthcare team a reliable sense of whether you’re experiencing cognitive symptoms that affect daily living.
4. Computerised Cognitive Tests and Devices
Medical devices and technologies are continually being updated and developed to assist doctors in evaluating cognition. Computerised testing software has several benefits that make it an effective diagnostic tool for Alzheimer’s, such as delivering the tests exactly the same way every time.
Digital assessments measure your performance on a number of cognitive or functional tasks. Your doctor will be able to determine whether you’re a good candidate for cognitive tests and devices. There may be alternative diagnostic tests that reach an accurate diagnosis more effectively.
5. Depression Screening
Your doctor will also evaluate your sense of well-being to determine whether you have any indicators of depression or other mood disorders. These may cause memory problems, loss of interest in life, and other symptoms that may be mistaken for those of Alzheimer’s.
Cognitive overlap symptoms between depression and dementia include:
- Memory problems: Forgetfulness can be a sign of both depression and dementia in older adults.
- Difficulty concentrating: Trouble focusing, thinking or making decisions.
- Slowed thinking: Slower processing speed and impaired working memory may indicate a lack of serotonin and dopamine, which can contribute to dementia- and depression-like symptoms.
- Lack of motivation: A loss of interest in activities or self-care is common for individuals with depression or dementia.
- Social withdrawal: You may isolate yourself from loved ones due to overwhelming negative emotions or confusion caused by dementia.
- Irritability and low mood: People with depression and dementia can easily become agitated, fidgety or persistently unhappy.
- Fatigue: Loss of energy or continuous tiredness is common in dementia and depression.
- Appetite changes: Unexplained weight loss from sudden changes in appetite may indicate depression or dementia.
- Sleep disturbances: Dementia and depression may cause changes in sleep patterns.
6. Brain Imaging
A standard physical examination for probable Alzheimer’s disease often includes structural imaging of the brain, which uses magnetic resonance imaging (MRI) and/or computed tomography (CT). These tests can rule out other conditions that may cause similar symptoms to Alzheimer’s.
For example, structural imaging can often be used to reveal tumours, damage from small or large strokes, traumatic brain injuries or a build up of fluid in the brain.
In certain cases, your doctor may order brain imaging scans to discover whether you have high levels of beta-amyloid, which is a common indicator of Alzheimer’s. While brain imaging can’t currently be used to confirm a dementia diagnosis, researchers are studying other techniques to better track the process of Alzheimer’s.
7. Cerebrospinal Fluid (CSF) Tests
CSF is a clear fluid that bathes and cushions the brain and the spinal cord. Adults have around one pint of CSF, which your doctor can sample with a simple procedure called a spinal tap. Research suggests that the early stages of Alzheimer’s may cause changes to CSF levels.
Certain CSF tests have been approved for widespread use, and these diagnostic tools can be used to detect beta-amyloid and tau markers in CSF, potentially predicting amyloid changes in the brain.
Why Are Diagnostic Tests Important for Individuals with Alzheimer’s?
While the idea of receiving an Alzheimer’s diagnosis might be daunting, diagnostic tests can bring a lot of comfort and knowledge to your circumstances.
These include:
- Diagnostic testing can rule out other conditions
Many conditions can mimic the symptoms of Alzheimer’s disease, such as thyroid problems, depression, infections or brain tumours. Diagnostic tests can rule out these other conditions, which may be treatable or reversible.
- Enable early access to treatment and support
While there’s no cure for Alzheimer’s, medications and other interventions can help manage symptoms and may slow cognitive decline, especially if started in the early stages of the disease.
Early diagnosis provides you with more opportunities to connect with care and support services, such as live-in and visiting care, which can significantly enhance your quality of life.
- Early diagnosis allows for future planning
Receiving a diagnosis while you can still actively participate in decision-making gives you the opportunity to make informed choices about your future care, living arrangements, and financial matters. This ensures your wishes are known and respected in the future.
- Provides an explanation and relieves anxiety
Knowing the cause of your symptoms can be a relief for you and your loved ones, resolving anxiety and uncertainty surrounding them. It can help everyone adjust to the changes and gain a better understanding of Alzheimer’s.
- Improves eligibility for participation in research
An early and accurate diagnosis often makes you eligible for a wider range of clinical trials, which are essential for advancing research and developing new, more effective treatments.
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