Is brain shrinking an Alzheimer's diagnosis?

1 answer | Last updated: Oct 30, 2016
A fellow caregiver asked...

A loved one has some small amount of shrinking of the brain as shown on MRI. Is this a diagnosis of Alzheimer's? If so how does this affect him emotionally?

Expert Answers

Lisa P. Gwyther, a social worker specializing in Alzheimer's services, is the author of The Alzheimer's Action Plan. An associate professor in the Duke University Medical Center Department of Psychiatry and Behavioral Sciences, she's also a past president of the Gerontological Society of America.

"Some small amount of brain shrinkage" on an MRI is not adequate for a diagnosis of Alzheimer's disease. No single test or MRI can be used by itself to diagnose Alzheimer's. Much depends on his age, other medical conditions, and most important, have there been changes in his ability to handle usual daily tasks? Have there been changes in behavior or personality, interest or energy level? If you are concerned about his emotions, he may have treatable symptoms of depression, anxiety or new emotional swings associated with early Alzheimer's disease. For example, some people with early Alzheimer's become more easily irritable or frustrated or they maylash out at family members in ways they have never done before. Some people withdraw or seem disinterested in family or usual activities. Some people with vascular dementia may have mood swings or sudden uncharacteristic crying spells. A diagnosis of Alzheimer's requires a thorough medical and neurological examination and a conversation with a family member or friend who knows him well. The key is how he has changed and what other conditions, instead of or in addition to Alzheimer's may be causing those changes. Ask this doctor or another doctor more questions beyond the MRI results.