Diagnosing Alzheimer's in Older People

As we get older our memory sometimes starts to fade, very often this is seen as one of the problems of growing old and just accepted as such by both the person's family and their doctor.

It is vitally important that a person receives a thorough examination when they are suffering from difficulties in thinking, remembering, learning or shows changes in their personality. Such an examination tells doctors several things such as the exact nature of the illness, the possibility of the condition being reversed or treated, the nature and degree of the illness and the areas which the person is able to function successfully.

It is essential that doctors establish any other health problems that the person may have and the need for treatment along with identifying a possible risk that such treatment may make the mental problems worse.

The social and psychological requirements and expected future changes have to be considered in addition to the available resources for the sick person, their family and their carer. Although the method and procedures may vary between different doctors, a thorough evaluation of the symptoms should include a medical and neurological examination, consideration of the person's support system and in order to maintain as much independence as possible, an assessment of their remaining abilities.

Evaluations can begin with the doctor taking a detailed history from a close relative or friend wherever possible. They will be asked how the person has changed, what symptoms they have had and information about other medical conditions. The person will also undergo a physical examination to check for other health problems.

Thyroid studies should be performed evaluate the function of the thyroid gland as problems associated with the thyroid gland are amongst the more common reversible causes of dementia. Blood tests to detect conditions such as anaemia, evidence of infections, problems with the functioning of the liver or the kidneys and diabetes will also be performed.

Should a physical examination fail to reveal the cause of the symptoms, an EEG (electroencephalogram), may be performed. This involves attaching small wires to the head records the electrical activity in the brain. This will diagnose any abnormal brain functioning.

CT, MRI, SPECT and PET Scans may also be used in addition to identify any changes in the brain such as Alzheimer's disease or strokes.

The Doctor may also request a neurological examination to reveal changes in the functioning of the nerve cells of the spine or brain. This examination can involve the person balancing with their eyes closed, checking reflexes in ankles and knees.

A mental status examination should also be performed. This involves the person being asked about the current time, date and place. The person's ability to concentrate, remember, carry out calculations and do abstract reasoning will be put to the test. Each of these tests should reveal any problems of function in the different parts of the brain.

A psychiatric and physiological evaluation is based upon interviews with the person and their family. It is important that the person's plan of care is established as early as possible. This evaluation is also an opportunity for the family to assess their own physical, financial and emotional abilities and is usually performed with the participation of a social worker or community nurse.

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