Alzheimer's Disease : Symptoms and Diagnosis

by National Institute on Aging

(Page 2 of 3)

Alzheimer's disease begins slowly. At first, the only symptom may be mild forgetfulness. People with Alzheimer's disease may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm.

However, as the disease goes on, symptoms are more easily noticed and become serious enough to cause people with Alzheimer's disease or their family members to seek medical help. For example, people in the later stages of Alzheimer's disease may forget how to do simple tasks, like brushing their teeth or combing their hair. They can no longer think clearly.

They begin to have problems speaking, understanding, reading, or writing. Later on, people with Alzheimer's disease may become anxious or aggressive, or wander away from home. Eventually, patients need total care.

An early, accurate diagnosis of Alzheimer's disease helps patients and their families plan for the future. It gives them time to discuss care options while the patient can still take part in making decisions. Early diagnosis also offers the best chance to treat the symptoms of the disease.

Slides of neurofibrillary tangles and amyloid plaques in brain tissue. Today, the only definite way to diagnose Alzheimer's disease is to find out whether there are plaques and tangles in brain tissue. To look at brain tissue, doctors must wait until they do an autopsy, which is an examination of the body done after a person dies.

Therefore, doctors must make a diagnosis of "possible" or "probable" Alzheimer's disease. At specialized centers, doctors can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors use several tools to diagnose "probable" Alzheimer's disease: Photo of Alzheimer's disease research lab.

A complete medical history includes information about the person's general health, past medical problems, and any difficulties the person has carrying out daily activities.

Medical tests - such as tests of blood, urine, or spinal fluid - help the doctor find other possible diseases causing the symptoms.

Neuropsychological tests measure memory, problem solving, attention, counting, and language.

Magnetic resonance images of normal versus Alzheimer's disease brains. Brain scans allow the doctor to look at a picture of the brain to see if anything does not look normal.

Information from the medical history and test results help the doctor rule out other possible causes of the person's symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood vessel disease in the brain can cause Alzheimer's disease-like symptoms. Some of these other conditions can be treated successfully.

Recently, scientists have focused on a type of memory change called mild cognitive impairment, or MCI. MCI is different from both Alzheimer's disease and normal age-related memory change. People with MCI have ongoing memory problems but do not have other losses like confusion, attention problems, and difficulty with language.

Scientists funded by the National Institute on Aging are conducting the Memory Impairment Study to learn whether early diagnosis and treatment of MCI might prevent or slow further memory loss, including the development of Alzheimer's.

Quiz

1. Alzheimer's disease comes on

A. progressively, over time.
B. quickly, with little advance warning.

A is the correct answer. Alzheimer's disease develops progressively over time and may last from 3 to 20 years, although the average duration after onset is from 8 to 10 years.

2. In the early stages of Alzheimer's, a common symptom is usually

A. dizziness.
B. forgetfulness.
C. loss of appetite.

B is the correct answer. Alzheimer's disease begins slowly, and at first the only symptom may be mild forgetfulness. People with early-stage Alzheimer's disease may have trouble remembering recent events, activities, or the names of familiar people or things.

3. A person with mild cognitive impairment, or MCI,

A. has trouble understanding language.
B. is disoriented and confused, but has few memory problems.
C. has ongoing memory problems, but without severe losses like confusion, attention problems, or difficulty with language.

C is the correct answer. People with MCI, or mild cognitive impairment, have ongoing memory problems but do not have other, more severe losses like confusion, attention problems, and difficulty with language. Scientists funded by the National Institute on Aging are conducting the Memory Impairment Study to learn whether early diagnosis and treatment of MCI might prevent or slow further memory loss, including the development of Alzheimer's disease.

4. Why is it important to have an early diagnosis of Alzheimer's disease?

A. So that the disease can be treated and possibly slowed.
B. So that the symptoms can be better managed.
C. So that other diseases can be ruled out.
D. All of the above.

D is the correct answer. Although there is no cure for Alzheimer's disease, early diagnosis makes it possible to consider various treatment options while the person with Alzheimer's disease can still take part in making decisions. Also, some medicines may help control certain behavioral symptoms of the disease. Caregivers can learn effective behavioral management strategies to cope with the symptoms associated with Alzheimer's. Finally, other diseases that sometimes mimic the symptoms of Alzheimer's can be ruled out or, if present, may be treated successfully.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.