Dementia--The Importance of an Accurate Diagnosis and the Qualified Specialists to Make It

Being able to retrieve information stored in memory becomes more difficult as we age, but recent memory loss so severe that it interferes with an individual's daily functioning is not part of the normal aging process. It is a symptom of dementia, a gradual decline of intellectual functions such as remembering, thinking and reasoning. The most common type of dementia is Alzheimer's disease (A.D.), a progressive, degenerative, terminal disorder that gradually damages and destroys nerve cells in the brain.

Although a definitive diagnosis of Alzheimer's can only be made by analyzing the brain on autopsy following death, current methods of evaluation by qualified doctors specializing in the care of senior adults can make a diagnosis of Alzheimer's 90% accurate. Other diseases that can cause similar symptoms can be ruled out in the process and treated.

What Should Be Included in an Evaluation?
It is important that the person suspected of having Alzheimer’s disease undergo a thorough physical, psychiatric, and neurological evaluation so that reversible conditions such as thyroid disease, metabolic problems, depression, adverse drug reactions, head injuries, etc. can be ruled out or treated.

There is no single diagnostic test for Alzheimer's, but physicians specializing in the care of the geriatric/elderly patient can reliably diagnose the disease with a series of evaluations and tests:

• Medical evaluation and family interviews—a detailed report from the patient and family member including observable changes and current symptoms.
• Physical exam including lab tests to identify health problems such as thyroid, vitamin deficiencies and diabetes that might be responsible for symptoms.
• Neurological exam including an EEG, an MRI and/or CT scan.
• Neuropsychological testing and mental status examinations which assess reasoning, word-finding skills, writing ability, abstract thinking and cognitive skills.

Who Should Do the Evaluation?
Most senior adults prefer to rely on the physicians they have been seeing for their medical needs for many years. But their doctor may not have the knowledge of current advances in evaluation tools, medications, and treatments that physicians who specialize in care of the geriatric patient, and in memory problems/Alzheimer’s disease in particular, do.

Physicians who specifically work with older adults may be:

• Family and Internal Medicine physicians with a geriatric specialty
• Geriatric Psychiatrists
• Neuropsychologists
• Neurologists with a specialty in Alzheimer's and Parkinson's diseases

If your family physician is not familiar with specialists in your area, your local Area Agency on Aging and Alzheimer's Association may be able to make recommendations.

Although there is no prevention or cure for Alzheimer's, early detection can allow the family and the individual time to plan for the future and make legal and medical decisions according to the individuals' wishes. Your loved one may have the opportunity to participate in one of the many research studies of experimental Alzheimer's treatments. Medications prescribed in early to middle stages of the disease can help slow the deterioration process.

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