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About Alzheimer's & Dementia

Warning signs Importance of getting a diagnosis

Video: Diagnosis FAQ with Dr. Eric Smith

Video: Diagnosis FAQ with Dr. Eric Smith

Importance of getting a diagnosis

If you are experiencing any memory loss, difficulty in making decisions, or getting more confused than previously, you are probably wondering whether it is part of normal ageing or some sort of dementia. You are not alone, because many people feel the same way. Though some memory loss, and difficulty recalling facts, is part of normal ageing, it should not cause difficulty in daily life. When you experience frequent problems with memory, decision-making, communicating with others, and changes in mood and behaviour and they are affecting your ability to carry on with daily life, it is likely to be dementia.

 

For instance, it is normal, as we age, to occasionally forget a name or an appointment, and recall it later. However, if you are forgetting important dates and events, and constantly repeating yourself, it is more likely to be due to dementia. Similarly, while it is normal to get confused with the settings of the television or microwave for functions not used on a daily basis, it is not normal if you are having difficulty doing familiar things such as cooking a meal or warming your food.

 

If you are seeing some symptoms in a family member and you are not sure whether you have to be concerned about it or not, please check the page on warning signs, or give us a call. A symptom tracking tool, named Mild Behavioural Impairment checklist, is available for families. The more frequently you are seeing those behaviour changes, the more likely is the possibility of dementia. Tracking these behavioural symptoms can help expedite an early diagnosis. The checklist can be accessed through the link given below.

https://mbitest.org/MBI-C_Sept2016.pdf

 

If you are concerned about symptoms you are noticing in a family member, or you are experiencing some symptoms yourself, it is important to see a physician and have it followed up. The symptoms that you are experiencing, or seeing in a family member, may or may not be due to dementia.

It may be due to some correctable causes such as Vitamin B12 deficiency, or thyroid disease, or could be due to dementia, such as Alzheimer’s disease.

 

Regardless of the nature of the diagnosis, there are some clear benefits to getting a proper diagnosis.  You get to try out the medications that are currently available, earlier on, in the course of the disease. This is especially true for Alzheimer’s disease, for which there is no cure at present; the medications currently available can help control symptoms, if taken in the early stages of the disease.  However, these medications do not work in the later stages of the disease. Therefore, if a doctor is giving a diagnosis of dementia, it is important to push for a complete diagnosis- regarding the type of dementia in the early stages itself. This might require a referral to a specialist such as a neurologist, geriatrician, or a geriatric psychiatrist and extensive workup, which could take some time. The course, progression, and treatment vary depending on the type of dementia.

 

Getting an early diagnosis of dementia also helps you plan for your future care and also organize all financial and legal affairs (such as will, advance directive, Power-of-attorney etc. ) in order. Instead of relying on a family member to make decisions, you will have some autonomy in making decisions regarding your future care. Getting a diagnosis also enables you to utilize resources available in the community and benefit from ongoing monitoring and support, all of which could help improve the quality of your life or the life of the person with dementia.

Is memory loss a normal part of aging?

As we age, it is normal to forget something such as a person's name or a scheduled appointment and then recall it later - but if you are not able to recall it at a later time, it could be due to dementia. Similarly, while it is normal to be confused sometimes about how to use unfamiliar settings on the T.V. or microwave, it is not typical to have difficulty performing daily tasks that were once very familiar - such as making a cup of coffee. 

See your doctor

If you are concerned about possible signs of dementia in a family member, or if you are experiencing symptoms yourself, it is important to consult a physician. Once the presence of dementia has been confirmed, it is helpful to have a complete diagnosis regarding the type of dementia. This might require a referral to a specialist such as a neurologist, geriatrician, or a geriatric psychiatrist for a more in-depth examination.

Regardless of the cause of these symptoms, there are clear benefits to getting a proper diagnosis and seeking the advice of your physician. Medications used to treat many types of dementia are more effective in the earlier stages of the disease. This is especially true for Alzheimer’s disease; the medications currently available can help control symptoms if started early. The course, progression, and treatment of these diseases will vary depending on the type of dementia diagnosed.

It’s also important to note that dementia-like symptoms may be caused by other conditions. Some people experience symptoms due to correctable causes such as Vitamin B12 deficiency, thyroid disease, depression and others.

If you need to find a family physician:

  • By telephone, dial 811 to contact Health Link
  • Use the College of Physicians and Surgeons of Alberta Find a Physician online tool (tick the "Accepting New Patients" box) or contact them by telephone at 780-423-4764
  • Use Primary Care Networks of Calgary and Area's Find a Doctor online tool, or fill out their online form (please note there is usually a waitlist for the form-based service)

Other benefits to timely diagnosis

A timely diagnosis also helps you plan for future care and organize financial and legal affairs (such as your will, personal directive and power-of-attorney). This will enable you or your family member to have some autonomy in making decisions. Getting a diagnosis also gives you access to support, care and resources available in the community and you may benefit from ongoing monitoring, all of which could help improve quality of life.

Diagnostic procedure

  • Diagnosis: There is no single diagnostic test for Alzheimer's disease or for any other cause of dementia. A diagnosis is usually made by excluding other causes that present with similar symptoms.
  • The diagnosis is made based on history, physical exam, blood tests, imaging, and cognitive assessment.
  • The physician would first take a detailed history from the person with memory concerns and from family members. This is followed by a detailed physical examination and blood tests to rule out conditions such as infections, vitamin  B12 deficiency, thyroid problems, diabetes and also test to assess kidney function and electrolytes.
  • Following the initial blood tests, the physician may refer the person to a specialist. The specialist may be a neurologist, a physician in geriatric medicine or a general psychiatrist or a geriatric psychiatrist. The person's memory and thinking skills will be assessed, initially with questions about recent events and past memories.
  • A cognitive assessment, such as Montreal Cognitive Assessment (MoCA) is also carried out. It is a questionnaire to assess short term memory, verbal fluency, verbal recall, ability to recognize patterns, and draw a clock.  A score above 26 is considered normal.
  •  A brain scan may be carried out to get some information about the changes taking place in the person's brain.
  • A CT scan would show conditions such as tumour, fluid in the brain, shrinkage of the brain, and vascular changes to a small extent. The MRI of the brain would show the above conditions in detail, and even show changes associated with mini-strokes in the brain. A PET scan (usually FDG or glucose PET scan) would show oxygen and glucose utilization in the different parts of the brain, which can help differentiate between Alzheimer’s disease from Frontotemporal dementia.
  • The diagnosis of the type of dementia is then made on the basis of the results obtained from all these investigations.

Video: Diagnosis FAQ with Dr. Eric Smith