How is Alzheimer’s Disease and Dementia Diagnosed?

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There is no single test that can determine if you have Alzheimer's disease, dementia, or a blend of both.
-Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN
Have you ever wondered why it takes so long to get to a diagnosis of Alzheimer’s disease or another type of dementia?
The good news is that it should take a bit of time - because it is a diagnosis of exclusion - meaning any other issues have to be ruled out. So it’s a little more complicated than a single test can tell us.
In today’s episode, I will walk you through the types of tests, exams, and screenings that should be done to help your provider get to a diagnosis. Stay tuned!
▶ How is Alzheimer’s Disease and Dementia Diagnosed?
Investigating possible causes and early diagnosis is important because:
While there is no cure, there may be another underlying cause that is treatable/ reversible, or you have time to make lifestyle modifications that may help manage the disease.
It can explain why you’re having a harder time with your memory or decision-making
You can make decisions about your future and communicate those to your loved ones
There isn’t a single test. Any type of dementia is a “diagnosis of exclusion.”
HISTORY
PHYSICAL EXAM
MEDICATION RECONCILIATION
COGNITIVE SCREENINGS
BLOODWORK
BRAIN SCAN
HISTORY
Social History (modifiable risk factors)
Family History
Medical History - chronic diseases
Surgical History - history of post-op delirium
Review of systems
PHYSICAL EXAM
Vital signs
Head-to-toe
MEDICATION RECONCILIATION
Review of prescription medications, supplements and over-the-counter medication
COGNITIVE SCREENING
Screening for Depression
Screening for Memory Issues
Basic parts of the test measure:
Orientation (date, day, year, month)
Language (verbal fluency and naming)
Reason and computation (calculation and abstraction)
Visuospatial ability (replicating a 3-D image, clock drawing test)
Executive function (problem-solving)
Memory
Mini-Cog
Mini-Mental State Exam (MMSE)
Montreal Cognitive Assessment (MOCA)
Self-Administered Gerocognitive Exam
The online test can be found here: wexnermedical.osu.edu/brain-s...
(There are 4 versions that you can download or you can take it online)
BLOOD WORK
BRAIN SCAN
Head CT and MRIs - Look at brain structure
PET Scan - Uses a small amount of radioactive substance to measure
brain activity; can measure abnormal protein deposits in the brain
SPECT: Single Photon Emission Computerized Tomography - A nuclear test that looks at blood flow and activity.
Get your checklist at melissabphd.com/diagnosischec...
#alzheimers #dementia #alzheimersawareness #caregiver #dementiaawareness #alzheimersdisease #seniorliving #homecare #healthcare #health #caregiversupport #care #memorycare #aging #thisisgettingold #melissabphd
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About MelissaBPhD
Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN. I am a nurse, nurse practitioner, nurse educator and nurse researcher with over 25 years of experience in the aging and long-term care healthcare space. You can visit my website at MelissaBPhD.com to learn more about me, how you can work with me directly, and/or support future episodes of the podcast. Within the first 18 months of launching this podcast, we reached a ranking of top 10% globally. I have all of you who’ve been with me on this journey so far to thank for that!
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[@FashionLover990]

He Melissa - thank you for your incredibly helpful videos. Apologies if you have already covered this topic - feel free to direct me to your video on this topic, if so. My father lost his vision from glaucoma approximately 2 years ago, then was diagnosed with Alzhimers earlier this year. The assessments you cover seem to depend significantly on someone being able to use their vision. Do you have experience with assessing and supporting people who no longer have their vision? We also recently lost my Mom/his wife, about 2 months after his diagnosis and I definitely saw the impacts of grief and trauma on his cognition. I've tried to support him in coming back from this as much as possible through anxiety medication and grief counselling, and am open to any suggestion for other options to support him through this incredibly challenging time of our lives.

[@MelissaBPhD]

Hi @FashionLover990, I don't have any content on supporting a person with vision loss but it's funny you mentioned it, because I had this thought yesterday. I will look into this and try to get something together over the next few weeks. I'm also launching a new "library" next week called AgeWiseU, where I've organized all of my content. If you're not on my email list, visit MelissaBPhD.com and sign up and you'll get information on joining that starting next Tuesday 3/19. As for grief and loss, right now, I only have 1 episode (that I can think of) on that topic - you can find that video here: melissabphd.com/ep-121-grief-and-loss-during-the-holidays/
Thank you for listening and for your comment/ questions! Sorry for the delay in getting back to you ~ launching this library has been a heavy lift, but it's almost ready to debut!

[@gofaux2007]

When you mention “seeing your provider” should that be an Internist or a neurologist?

[@MelissaBPhD]

@@gofaux2007 - I would start with primary care/ internal medicine for screening and ruling out other causes. They may then refer to a neurologist or neuropsychiatrist for a more in-depth assessment.

[@MelissaBPhD]

True that the screenings have to take functional and sensory changes (like vision loss, manual dexterity, etc). They are screening tools, not diagnostic. And he should be evaluated for depression. If your primary care provider takes the time to do an in-depth social history, runs labs, etc, they should be able to decide if they should start treating the depression and see if his cognition improves. Depression can look like dementia, so would be worth having him evaluated and try an antidepressant for a few months to see if it helps. Thanks for the comment - I have no idea why I didn’t see this before, so my apologies for the delay