Diagnosing Alzheimer's
Posted on Wed, Dec 16, 2009 @ 10:00 AM
At MidAmerica Neuroscience Institute, we have a
memory loss center and the reason we feel it is important to have a dedicated area within the practice to deal with memory loss is quite simple. Memory disorders are very common and it can be confusing for families and patients experiencing a memory disorder, or other thinking problems, about how they should proceed with care. Often, they may wander from physician to physician and they may call the Alzheimer's Association to get more information. They may go on the Internet and look for things, but what is really needed is a diagnosis. Do you really have a memory problem or are you just distracted and anxious? Are you multi-tasking too much? And if you have a memory problem, what is the cause of it? The underlying cause is important because there are treatments for most memory disorders - cures for a few - but treatments for almost all. Learning which type memory disorder you have is very important.
Alzheimer's, Dementia And Senility... Are They All The Same?
We used to think that as we got older some of us got senile. That was a word that was used in the past, but in the 1970s and 1980s, for the first time, investigation was carried out to find out what causes senility; why do people become senile. The answer was quite startling. It turned out that almost all of the people who had been diagnosed with senility, once they passed away and an autopsy was done, their brains revealed straightforward Alzheimer's disease. It was not until the 1970s or 1980s that we realized that almost everything we had been calling senility was simply Alzheimer's disease. This kicked off an avalanche of research into that disease which is just now coming to fruition. There are several treatments for Alzheimer's disease, all of which a neurologist at a dedicated memory loss center will be well versed in; as we are at MidAmerica Neuroscience Institute.
New Alzheimer's Treatments
There are a number of treatments still under research and just on the cusp of becoming available to the general public. We are heavily involved in that research. Currently, we have several trials of different treatments and medications for Alzheimer's that are ongoing. Eventually within the next 5-10 years, we hope to see a cure for Alzheimer's, so it is very important to treat people now and keep them as sharp as possible for the contingency that there may turn out to be a cure in the very near future.
How Common Is Alzheimer's Disease?
How common is Alzheimer's disease alone? It is estimated that 5-10% of all Americans by age 65 have a diagnosis of Alzheimer's disease. By age 85, almost half of all Americans have a diagnosis of Alzheimer's disease. Therefore, this is one of the most common disorders that exist and it is very likely that every family has been, or will be touched by it in some way.
Is Alzheimer's Genetic?
I am often asked, "Do you inherit the propensity to get Alzheimer's or other dementias?" They answer is there is a little bit of increased risk if you have a lot of relatives with Alzheimer's and slightly decreased risk if you do not, but the fact is that it is a very common disease. Alzheimer's is one of several diseases that cause what we term dementia. Dementia is a scary word which simply means you do not think now as good as you used to think.
Alzheimer's can cause this problem, but so can a number of other issues. Hardening of the arteries is an old term for something that we now call vascular dementia. It turns out that it is really not all that common, but it is important to diagnose correctly and at our memory disorders center we are well versed in that. It turns out that just because you have a few strokes on your MRI does not mean that you have vascular dementia or hardening of the arteries. There are certain other criteria that have to be met. Through our participation in clinical research at our facility, we feel like we are well placed to make that discernment for a patient.
Other Types Of Dementia
Besides vascular dementia and Alzheimer's, there are many other causes of dementia, frontotemporal dementia, primary progressive aphasia, Lewy Body disease, Jakob-Creutzfeldt disease, limbic encephalitis, etc. The diagnosis is important and to arrive at this we use very specialized MRI sequences at MidAmerica Neuroscience Institute looking at certain areas of the brain that are of high interest to us. We also obtain EEG's, certain lab work and very often a sleep study is indicated if the individual has problems with sleep.
Some things can masquerade as dementia - like depression. But on the other hand, patients with Alzheimer's and other dementias are prone to depression. It is very important to sort out whether it is depression alone or if it's a response to some other disease. Other mimics for dementia include sleep disorders - if you're very sleep deprived you don't think well the next day and if that's your only problem and it is corrected, your thinking could be fixed.
Certain vitamin deficiencies like B12 vitamin E if significant enough could cause thinking problems bad enough to be mistaken for dementia - and those are correctable and treatable. A brain tumor, aneurisms or even cancer of various kinds also can cause various kinds of thinking problems and it's important to find those types early for the best chance of curing the problem. The first and most important step is getting to a facility where an accurate diagnosis can me made. - by Dana Winegarner, DO