FAQ: What Kind of Experts Can Diagnose Alzheimer's Disease?
What kind of experts can diagnose Alzheimer's disease?
A physician is in the best position to diagnose Alzheimer's disease, because he or she can conduct a physical examination and the testing necessary to rule out other possible causes for memory loss and other symptoms of dementia.
Most people start with their regular primary care physician. Possibly the most useful quality he or she can have is a lot of experience diagnosing Alzheimer's. A geriatrician (physician who specializes in aging) is a good doctor to start with for this reason, but geriatricians are in short supply and can be hard to find.
Other clinicians who may be involved in diagnosing Alzheimer's dementia include neurologists, geriatric psychiatrists, and neuropsychologists. Psychologists and professionals such as geriatric social workers can conduct cognitive screening tests to determine whether someone has dementia symptoms that warrant further checking, but these tests alone can't diagnose Alzheimer's disease. For that, you'll need a complete clinical assessment.
There is a difference between Alzheimer's disease and Dementia.
Dementia is more severe. The person is in or out of memory experiences and becomes agitated and violent. There is a more extreme occurrence of "Sundowning," where they are agitated and anxious during sunset.
The medications are different, too. Alzheimer's is a more milder short term forgetting. Medication is Aricept. BUT, Dementia would be Excellon, it is not a dopamine deficiency but Acetacolyine deficiency.
If you have the money, get a SPECT or PET scan. The neurologists have the areas deficient in the brain that correspond to the specific type of medication needed.
And a note of extreme caution: most doctors will medicate patients in hospitals and the drugs to curb their agitation could kill them. Heart patients will find the dementia especially painful, because the heart problems invalidate most medications that curb agitation and depression.
I am a health care professional dealing with memory-impaired and head trauma patients for over 20 years.
Music and a determined daily regimine seem to calm the agitation. My last client was an ex-police chief from Boston area. In his latter stages he not only saw "dwarf like people " in the room, voices were whispering to him.
His rage attacks were worse. When he was hospitalized, they put him in a psychiatric ward with no monitors. He fell and broke his hip. His agitation was increased by the reactions to the anesthesia during the operation. They physically restrained him in the hospital because of his reactions and lack of memory as to where he was. It was awful.
Staff in most hospitals and facilities are not prepared for dementia. They will write "refused" for a patients' denial of food, water and pills. You have to have sitters in the hospital with them 24/7.
My mom is 91, she fell and broke her hip. Its obvious she has eithe dementia or alzheimers. When leaving her physical therapy nursing home; discharge orders recommended a full neirological work up for a diagnosis. Given she had been observed for 90 days and had her blood drawn twice- I asked "why?" It's obvious she is not all here- can't remember days, date, time, if she ate lunch, my name at times- and sometimes easy items such as pear, apple and plum are foreign. This isn't rocket science. But, I took her to her doctor for follow-up and showed him. He's a good geriatric doctor. He said "you can but I don't think that it's necessary to put her through something that will just frustrate her". He asked her a few simple questions, read the nursing home notes, asked me what I saw and wrote "moderate dimentia" as the diagnosis. My point- start with your Geriatric doctor first. He may want to do a blood draw and URINE because elderly tend to get UTI's without symptom - except they go a little bonkers. If that is the xase- antibiotics will clear up a lot of confusion. When my mom gets worse than normal- UTI is the first suspect
I wanted to add- that also mom had her head looked at after her fall so it could be that a neurologist already reviewed the scan. I know they wanted to rule out a stroke. I forget sometimes that sometimes the full scope of any story can be missed. So start with a good Geriatric doctor. My point is- don't unnecessarily frustrate the elderly. I think we over use the medical profession for what is normal aging- then we fill them up with pills. All I cared about was 1. Helping her depression because her sadness breaks my heart and 2. Helping with her anger outbursts because her frustration of her lost independence is difficult. He memory loss- I just join in the fun. She's told some whopper stories! I write them down so I can remember all of mom.
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