Alzheimer’s disease is the most common form of dementia. It affects over 5 million Americans. It’s also the sixth leading cause of death in the U.S.
Too many people ignore signs of dementia and don’t discuss it with their physician. Studies show about 50% or less of people with dementia are diagnosed by their primary care physician.
Are you worried about a parent or loved one? Make sure you understand the tests for dementia and Alzheimer’s.
Read on for more information about tracking a parent’s cognitive health.
The 5 Signs of Dementia
A diagnosis of dementia means a person has all 5 of the following problems:
- One or more types of mental function are difficult.
- The difficulties are a decline from previous levels of ability.
- Daily life functions are impaired by the difficulties.
- A reversible condition is not the cause of the problems.
- The problems aren’t caused by another mental disorder such as schizophrenia.
Dementia is not a specific disease. It’s a syndrome that falls in the category of “major neurocognitive disorder.” Alzheimer’s is a disease that’s a common underlying cause of dementia.
Cognitive Functions
When determining whether a person has dementia, the six cognitive functions considered are:
- Learning and memory
- Language
- Executive function
- Complex attention
- Perceptual-motor function
- Social cognition
Tests for Dementia and Alzheimer’s
There is no single test for determining dementia or Alzheimer’s disease.
An absolute diagnosis of Alzheimer’s can only be had through an autopsy upon death. But there are tests that help determine if the probable cause of impairment is dementia.
The doctor evaluates each aspect of a patient’s physical and cognitive function. This includes taking cognitive tests. It also includes lots of questions for the patient and family.
It also includes physical tests for possible underlying causes of dementia.
First Step: Physical Exam
The first step is a physical exam. The doctor takes a medical history. The doctor needs information like past illnesses, current medications, and past family history.
Be candid with the doctor. Don’t hold back information involving drug or alcohol abuse. Tell them if the parent’s nutrition is poor. Do they eat all processed foods and junk? Tell the doctor.
The doctor takes blood and urine samples for routine tests. He tests for thyroid abnormalities, diabetes, and other conditions.
There are several reversible causes of dementia. These include:
- Drugs
- Emotional causes like depression
- Metabolic problems such as hypothyroidism
- Problems with eyes and ears
- Tumor
- Infection such as AIDS or syphilis
- Anemia
The doctor first rules out any possible reversible physical causes of cognitive decline. Upon finding a physical condition, the doctor will treat that first.
If there are no physical problems, the doctor moves on to other tests.
Neurological Exam
Some patients have brain disorders that impair memory function. The doctor looks for signs of stroke. She’ll also rule out brain tumors, Parkinson’s disease, and fluid accumulation on the brain.
Reflexes, coordination, muscle tone, and strength are all tested. Eye movements, speech, and sensation are also examined.
Mental Function Assessment
The doctor performs in-office cognitive tests. But information from close relatives, friends, and the patient is also documented. The Montreal Cognitive Assessment (MoCA) is one memory test a doctor might perform.
The MoCA is a time-consuming test. Some seniors may balk at taking it.
A mini-mental status exam (MMSE) is performed. This includes a series of questions testing a range of everyday mental skills.
The doctor performs a mini-cog as well. This is two tasks. The patient is asked to remember several words. After a few minutes, the doctor will ask the patient to repeat back the words.
The doctor also has the patient draw the face of a clock with all 12 numbers. The doctor asks the patient to put the hands of the clock on a time he specifies.
While tests are important, information from daily living is often more helpful.
Questions when Testing for Dementia
There are some standard questions a doctor will ask when testing for dementia:
- Does the patient have memory loss?
- Is memory loss disrupting daily life?
- Is the patient challenged when it comes to problem-solving?
- Is the patient showing signs of poor judgment like overspending or ignoring safety?
- Has the patient lost interest in his favorite hobby or leisure activity?
- Is the patient repeating stories and questions more than usual?
- Is he having trouble learning new things?
- Does the patient forget what month or year it is?
- Is the patient forgetting appointments and plans?
- Is the patient confused and struggling with thinking or memory?
The answers to these questions help the doctor determine whether the patient has Alzheimer’s.
Brain Scans
Magnetic Resonance Imaging (MRI) scans and Computed Tomography (CT) scans rule out other conditions. These scans detect strokes, tumors, or fluid on the brain.
The human brain shrinks about 1% a year as people get older. With Alzheimer’s, the brain shrinks about 3% per year. Annual brain scans show whether there is unusual shrinkage of the brain.
Beware of Home Tests for Dementia and Alzheimer’s
Be skeptical of tests marketed to consumers. These home tests aren’t proven to be scientifically accurate. Worse, they can give false positives. The test result may show dementia when the patient doesn’t have it.
A doctor is unlikely to diagnose dementia or Alzheimer’s if the patient doesn’t have it. Diagnosis may take several months or even years. A person with memory problems should see the doctor every 6 to 12 months.
Diagnosing Dementia and Alzheimer’s
There are no definitive tests for dementia and Alzheimer’s. But visit the doctor if you suspect a loved one has memory loss.
People are afraid of a diagnosis of dementia or Alzheimer’s. This is understandable. But, early diagnosis and intervention staves off institutionalization. It also helps someone prepare for future memory loss.
Through a physical exam and a battery of tests, a doctor has a good idea of whether a patient has dementia or not.
Do you have a loved one with dementia? With proper care, he can live a full life. Need help caring for a loved one with dementia or Alzheimer’s? Look into a memory care community today.
