Why wouldn't a neurologist diagnose dementia or Alzheimer's?

A fellow caregiver asked...

WHY IS IT THAT PATIENT'S NEUROGIST WON'T DIAGNOS DEMENTIA OR ALZHEIMERS WHEN PATIENT HAS PRETTY MUCH ALL THE SYMPTOMS. FROM THE INFO THAT I HAVE GOTTEN FROM THIS WONDERFUL SITE IS THE OPINION THAT HE LATE YO MODERATE. I HAVE BEEN UNDER THE IMPRESSION THAT ARE SOME MEDS THAT MAY HELP BUT IF THE DR WON'T DIAGNOSE IT THERE WILL BE NO MEDS. I HAVE ASKED NEUROLOGIST & PRIMARY DR ABOUT THIS TO NO AVAIL. I AM SO VERY FRUSTRATED BECAUSE I AM EXHAUSTED AFTER WORKING ALL DAY (AGE 63 & HAVE FEBROMYALGIA & RHEUMATOID ARTHRITIS) & THEN I COME HOME TO FIND ALL KINDS OF THINGS THAT HAVE HAPPENED DURING THE DAY PLUS THEN MOST OF THE NIGHT I AM TAKING CARE OF HIM & MESSES & HELP WITH ALL KINDS OF THINGS THAT HAVE TO BE DONE. A THERAPIST ONCE TOLD ME THAT THE PERSON LIVING WITH THE PATIENT KNOWS IF HE HAS DEMINIA BECAUSE THAT PERSON HAS SEEN THE PATIENT IN PAST YEARS WHEN HE DIDN'T SHOW SIGNS OF THE DISEASE. CAN YOU PLEASE SHED SOME LIGHT ON THIS SITUATION. THANKS

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

You don't say what your relationship is with this person, so I'll take the liberty and assume it's your husband.

These days many doctors will administer a "mini-mental" test to anyone over 75 as part of routine annual physicals. This test gives a preliminary indication of short-term memory loss. I assume that his doctor has already done so. Hopefully he has also undergone further testing to eliminate other conditions that mimic dementia, such as dehydration, low-grade infections, malnutrition and NPH, just to mention a few. NPH stands for Normal Pressure Hydrocephalus, which is an excess of fluid on the brain, which of course can affect a person's thinking and behavior. Many of these are reversible if detected early. You might want to get a second opinion, preferably from a geriatrician.

If he does have dementia, there are medication that may help, however, there's no such thing as a magic bullet: Aricept, Razadyne or Exelon, which are all in the same class: acetylcholinesterase inhibitors; either one of these three is often combined with Namenda. These medications work really well for some people, others find only moderate relief and for others, the side-effects are too severe.

With or without the medication, there are many strategies you can employ to ease your burden and help him have an easier life. Caring.com has many suggestions for you. You may also want to go on my website: www.alzatoz.com

By the way, referring to the therapist; he/she is right probably about half of the time. Every situation is unique: sometimes the family is the first to recognize problems; sometimes however, they are the last to notice, because the progression has been so gradual that they have simply readjusted themselves to the behavior.