Good Afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is how Alzheimer’s is diagnosed and when you should see a doctor.
Eighteen years ago my life changed forever with these four words. “Your mother has Alzheimer’s.” I sat there… numb. What do you do when your worst fears are realized? How do you react when you find out that one of the people you love the most in this world is sick and for them, there’s no getting better? What do you say when your world is turned upside down?
I don’t know if there was a part of me that was expecting to hear that Mom wasn’t suffering from depression as I was led to believe. I do know I wasn’t prepared to her the doctor say it was Alzheimer’s. It took a long time to digest the meaning and magnitude of those words. It was equally as devastating knowing I would never have the mother I knew and loved back again.
I couldn’t get my mother out of my mind. Thoughts of her and her diagnosis continued to weigh heavy on my mind and heart. The more I read, the more I realized the importance and necessity of getting a second opinion. Perhaps nothing would change but, on the other hand, maybe it would.
I didn’t want my father to accept the doctor’s opinion as something that was cast in stone. For the sake of all concerned he should have someone else examine her. I had to wonder if with some therapy and different meds, we wouldn’t see an improvement in my mother. I wondered how much of the way she was acting was due to the drugs she was taking rather than Alzheimer’s. Then there was her thyroid problem and age. It all added up to at least seeking another opinion.
I’m not alone in this battle. It’s estimated that nearly 500,000 new cases of Alzheimer’s will be diagnosed this year alone.
That’s what brought me to today’s topic.
Surveys show that many people who care for those with clear signs of memory loss often wait two to three years before seeking a diagnosis. Some well-intentioned caregivers may think they’re protecting a loved one from worry or depression by delaying a dismal diagnosis. Such was the case with my father.
Others worry that receiving a diagnosis would be a self-fulfilling prophecy and somehow worsen symptoms of the disease. But ignorance is by no means bliss. In fact, living with undiagnosed memory loss, chronic confusion and other symptoms of Alzheimer’s is worrisome, distressing and frequently depressing.
Delaying diagnosis also can make it more difficult to treat symptoms. Medications available to treat symptoms of AD usually work best in the early stages of the disease. While those drugs don’t halt the course of the illness, they’re known to improve the quality of life for some individuals and caregivers.
So if someone you know is having trouble thinking, remembering or learning or exhibits changes in their personality it’s time they see a doctor.
There’s no single test that can show whether a person has Alzheimer’s. Diagnosing AD requires careful medical evaluation that includes:
· A thorough medical history
· Mental status testing
· A physical and neurological exam and
· Tests (such as blood tests and brain imaging) to rule out other dementia-like symptoms
If your primary care doctor suspects possible Alzheimer’s they may refer you to a specialist who can provide a detailed diagnosis. Or you may decide to go to a specialist on your own.
Finding the right doctor is important. Experts estimate a skilled physician can diagnose Alzheimer’s with more than 90 percent accuracy. The first step in following up on symptoms is finding a doctor you feel comfortable with. You can start with your regular primary care physician or internist about your memory loss concerns. Primary care doctors often oversee the diagnostic process themselves. They also may refer you to a physician who specializes in diagnosing and treating Alzheimer’s and related dementias.
· Geriatricians manage health care in older adults. They know how the body changes as it ages and whether symptoms indicate a serious problem.
· Geriatric psychiatrists specialize in the mental and emotional health of older adults and can assess memory and thinking problems.
· Neurologists specialize in brain health and the central nervous system. They can conduct and review brain scans, including CTs and MRIs.
· Neuropsychologists can conduct memory and thinking tests.
Prior to your doctor’s appointment you should:
· Be aware of any pre-appointment restrictions.
· Write down any symptoms, including ones that may seem unrelated to the reason you made the appointment.
· Write down key personal information, including any major stresses or recent life changes.
· Make a list of all your medications.
· Enlist a family member, friend or caregiver to go with you.
Preparing a list of questions will help maximize your time with the doctor. List questions from most important to least important in case time runs out. Some basic questions to ask are:
· What is likely causing my symptoms?
· Are there other possible causes for my symptoms?
· What kinds of tests are necessary?
· Is the condition likely to be temporary or chronic?
· What’s the best course of action?
· What are some alternatives to the primary approach being suggested?
· How can dementia and other health issues be managed together?
· Are there any restrictions?
· Is there a generic alternative to the medication being prescribed?
· Is there any printed material I can take home with me? Any websites I can visit?
Ask the doctor to talk plainly to you. Don’t hesitate to ask questions if you don’t understand something and don’t leave until you feel like you know what’s been said. Be sure to write down things you need to remember.
In turn, the doctor will most likely ask you some questions, such as:
· What symptoms are you experiencing? Are you having trouble finding words, remembering events or focusing attention? Are you getting lost or experiencing personality changes?
· When did your symptoms start?
· Have they been continuous or occasional?
· How severe are they?
· What, if anything, seems to improve your symptoms?
· What appears to worsen them?
· Is there a family history of dementia or related conditions, such as Huntington’s or Parkinson’s disease?
· Are there any activities you’ve had to stop because of difficulty thinking through them?
Although the onset of Alzheimer’s can’t be stopped or reversed, an early diagnosis allows those individuals with dementia and their families:
· A better chance of benefiting from treatment
· More time to plan for the future
· Lessened anxieties about unknown problems
· Increased chances of participating in clinical drug trials
· An opportunity to participate in decisions about care, transportation, living options and legal and financial matters
· Time to develop a relationship with doctors and care partners and
· Benefit from care and support services, making it easier for them and their families to manage the disease.
The process of diagnosing Alzheimer’s has become more accurate in recent years. Specialists can collect and analyze a range of indicators to determine whether and why a problem may exist and how it should be treated.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me at 1 pm Monday when my topic will be “The New Normal: How Your Body, Brain and Memory Change with Age.”