TO YOUR HEALTH
Diagnosing Alzheimer’s Disease and Comparing Early Symptoms to Normal Aging BY STEPHEN A. WILSON Alzheimer’s disease (AD) is a scary thing. In a recent survey, it was the disease most feared by more than 50% of British adults. Not all dementia is AD; for example, vascular dementia, which can be the end result of chronic diseases, most commonly stroke, that result in decreased blood flow to parts of the brain. However, AD is the most common and well-known type and will be our focus. From the U.S. National Institute of Health, Alzheimer’s disease is a degenerative brain disorder characterized by progressive loss of memory and cognitive abilities. It is marked by the accumulation of amyloid plaque and neurofibrillary tangles in the brain, which can disrupt normal brain function. AD typically begins in the mid-60s. Over time, it leads to severe impairment that affects activities of daily living (ADLs). 12
ADLs is a specific medical term that refers to five essential self-care tasks and abilities that people perform independently daily to maintain their health and well-being. • Eating: Feed oneself • Bathing: Wash oneself • Dressing: Put on and take off clothing • Toileting: Use the bathroom • Mobility: Move around safely People with AD experience insidious onset of progressively losing their memories, their ability to learn, and their capacity to perform ADLs. Diagnosing AD requires a comprehensive clinical evaluation combining medical history, cognitive assessment, and corroboration from family members or close contacts. Clinical evaluation begins with assessing cognitive decline across multiple domains, including memory, language, attention, visuospatial thinking and awareness, executive function (working memory, flexible thinking, selfcontrol), and mood. Initial assessment involves one or more brief screening questionnaires (e.g., Montreal Cognitive Assessment – MoCA, Mini Mental Status Exam – MMSE, AD8, IQCODE, Mini-COG, and SLUMS are some common ones). If the diagnosis remains uncertain, neuropsychological testing becomes necessary. Doctors will also order blood tests looking for possible non-AD causes of the symptoms, for example syphilis, B12 deficiency, or liver, kidney, electrolyte or NBUSA Quarterly