Alzheimer's Disease

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Alzheimer's Diagnosis

The diagnosis of Alzheimer's disease involves taking a detailed history of symptoms and ruling out other treatable medical and psychological conditions that cause loss of cognitive function (dementia), such as the following:

• Depression
• Head trauma
• Infection (e.g., HIV, syphilis)
• Intoxication or withdrawal from medication, poison, or substance of abuse
• Kidney disease
• Liver disease
• Neurodegenerative diseases (e.g., Creutzfeldt-Jakob, Huntington's)
• Seizures (epilepsy)
• Thiamine or vitamin B deficiency
• Thyroid disease
• Tumor

Normal effects of aging must be ruled out as well.

A mental status examination reviews systems of higher mental function. This involves asking questions to evaluate mental functions and making observations of the patient's behavior, appearance, and attitude. Questions are designed to assess orientation, memory, attention and concentration, insight and judgment, general intellectual functions (e.g., calculation; common knowledge, such as What is the capital of the United States?; identifying similarities and differences between words).

Slowly progressive loss of memory and orientation, normal lab test results, and brain imaging scans that show atrophy of the cerebral cortex and hippocampus indicate a diagnosis of Alzheimer's disease.

Diagnostic Tests
Routine blood, serum, and plasma analyses can identify the presence of most diseases mentioned. Brain imaging studies are capable of identifying the presence of tumor, head trauma, and neurological conditions.

Magnetic resonance imaging (MRI) or computed tomography (CT) scans show diffuse atrophy of the cerebral cortex and hippocampus in Alzheimer's disease. Neuroimaging may be normal early in the disease.

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