Diagnosis
Introduction
Finding the right doctor
Evaluating mood and mental status
Physical exam and diagnostic tests
Neurological exam
When the diagnosis is Alzheimer's
Introduction
Often people with severe memory loss or other possible warning signs of Alzheimer's are not aware of the problem. They may resist following up on their symptoms. Signs of dementia may be more obvious for family members or friends. While there is no single test that proves a person has Alzheimer's, a doctor can diagnose Alzheimer's with more than 90 percent accuracy.
Finding the right doctor
The first step is to find a doctor you feel comfortable with. Your local Alzheimer's Association can help.
There is no single type of doctor who specializes in diagnosing and treating memory loss or Alzheimer's. Many people contact their regular primary care doctors or internists about their concerns. Primary care doctors often oversee the diagnostic process and provide treatment themselves.
In many cases, the primary care doctor may refer a patient to a specialist, such as a:
- Neurologist, who specializes in diseases of the brain and nervous system
- Psychiatrist, who specializes in disorders that affect mood or the way the mind works
- Psychologist with advanced training in testing memory, concentration, problem solving, language and other mental functions
Evaluating mood and mental status
Mental status is tested to give the doctor a general idea of how well the mind is working. This testing gives an overall sense of whether a person:
- Is aware of having symptoms
- Knows the date, time and where he or she is
- Can remember a short list of words, follow instructions and do simple calculations
The doctor may ask the person his or her address, what year it is or who is serving as president. The individual may also be asked to spell a word backward, draw a clock or copy a design.
The doctor will assess mood and sense of well-being to detect depression or other illnesses that can cause memory loss and confusion.
Physical exam and diagnostic tests
The doctor will perform procedures to assess the person's overall health like evaluating diet, checking blood pressure or listening to the heart. Blood and urine samples will be collected, and other laboratory tests may also be ordered.
Information from these tests can help identify disorders such as anemia, diabetes, kidney or liver disease, certain vitamin deficiencies, thyroid abnormalities, and problems with the heart or blood vessels. All these conditions may cause confused thinking, memory problems or other symptoms similar to dementia.
Neurological exam
A doctor, sometimes a neurologist who specializes in disorders of the brain and nervous system, will closely evaluate the person for problems that may signal brain disorders other than Alzheimer's.
The doctor will also test the person's reflexes, balance, eye movement, speech and sensation. The doctor is looking for signs of small or large strokes, Parkinson's disease, brain tumors, fluid accumulation on the brain, and other illnesses that may impair memory or thinking.
The neurological examination may also include a magnetic resonance imaging (MRI) or computer tomography (CT). MRIs and CTs can reveal tumors, evidence of small or large strokes, damage from severe head trauma or a buildup of fluid. Medicare will cover a positron emission tomography (PET) scan as an aid in diagnosis in certain cases.
When the diagnosis is Alzheimer's
Once testing is complete, the doctor will review results and share conclusions. A diagnosis of Alzheimer's disease reflects a doctor's best judgment about the cause of a person's symptoms.
You may want to ask the doctor to explain:
- Why the diagnosis is Alzheimer's
- Where the person may be in the course of the disease
- What to expect in the future
Find out if the doctor will manage care going forward and, if not, who will be the primary doctor. The diagnosing doctor can then schedule the next appointment or provide a referral.
A diagnosis of Alzheimer's disease is life-changing for both diagnosed individuals and their families. While there is currently no cure, treatments are available that may help relieve some symptoms.
Next: Treatments
簡介
尋找恰當的醫生
評估情緒和精神狀況
體驗和診斷試驗
神經檢查
當診斷出患阿滋海默症時
簡介
通常出現嚴重記憶喪失或阿滋海默症的其他可能警訊的人不知道識別此問題。他們可能不願意對他們的症狀進行追蹤。失智症的徵兆可能對家人或朋友來說更加明顯。儘管沒有一個試驗檢查可證明某人患有阿滋海默症，但醫生診斷阿滋海默症的準確度超過 90%。
尋找恰當的醫生
第一步是尋找讓您感到輕鬆自在的醫生。您當地的 Alzheimer's Association阿滋海默症協會 可提供協助。
沒有任何一類醫生專門診斷和治療記憶喪失或阿滋海默症。許多人與他們的主要照護醫生或內科醫生聯絡，以瞭解他們關心的問題。主要照護醫生通常會監督該診斷過程並親自提供治療。
在許多情況下，主要照護醫生可將患者轉診至以下專家：
- 神經科醫生，專門診治大腦和神經系統疾病
- 精神病醫生，專門診治影響情緒和思維方式的病症
- 心理學家，其接受了測試記憶力，注意力，問題解決，語言和其他心理功能方面的進階訓練
評估情緒和精神狀況
對精神狀況的測試旨在使醫生大致瞭解患者的智力情況。此測試會使醫生總體瞭解患者是否：
- 知道自己出現症狀
- 知道日期，時間和自己所在的位置
- 能夠記起簡短的單字清單，聽從指示，以及做簡單計算
醫生可能詢問此人的地址，今年是哪一年，或者總統是誰。還可能要求此人倒著拼寫單詞，畫個時鐘，或者複製一個設計。
醫生將評估情緒和幸福感，以檢測此人是否患有抑鬱症或可能導致記憶喪失和精神錯亂的其他疾病。
體驗和診斷試驗
醫生將執行評估病人整體健康情況的程序，例如評估飲食，檢查血壓或者聽心臟。將收集血液和尿液樣本，還可能安排進行其他實驗室試驗。
從這些試驗中獲得的資訊可協助確定病症，例如貧血，糖尿病，腎病或肝病，缺乏某些維生素，甲狀腺異常，以及心臟或血管問題。所有這些情況均可能導致思維錯亂，記憶問題或類似於失智症的其他症狀。
神經檢查
醫生，有時為專門診治大腦和神經系統疾病的神經科醫生，將密切評估患者是否出現可能引發大腦功能障礙的問題，而非阿滋海默症。
醫生還將測試患者的反射作用，平衡，眼光移動，語言和感覺。醫生尋找以下問題的徵兆：輕微或嚴重中風，帕金森氏症，腦瘤，腦積水，以及可能損毀記憶力或思維能力的其他疾病。
神經檢查還可能包括核磁共振 (MRI) 或電腦層析成像 (CT)。MRI 和 CT 可顯示腫瘤，輕微或嚴重中風跡象，嚴重頭部創傷造成的損毀或腦積水。Medicare 將承保在某些情況下作為診斷輔助的正電子發射電腦斷層 (PET) 掃描。
當診斷出患阿滋海默症時
測試完成後，醫生將檢視結果並通知主要照護醫生結論。阿滋海默症的診斷展現了醫生對患者症狀原因的最佳判斷。
您可能想要讓醫生解釋：
- 為什麼診斷結果為阿滋海默症
- 此患者可能處於該疾病的哪一階段
- 未來預計會怎樣
弄清楚醫生是否將管理未來的護理，如果不是，誰是主要醫生。然後診斷醫生可安排下一次預約或提供轉診。
阿滋海默症的診斷會改變就診者和他們家人的生活。儘管目前無法治癒該疾病，但透過治療可協助緩解一些症狀。
下一頁：治療
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