As Alzheimer’s research changes often, having a diagnosis can be confusing. Here are key questions you may not think to ask your doctor, along with notes on why they’re important.
How can we be sure my symptoms aren’t the result of a stroke, mental illness or another treatable condition?
There is no definitive test for Alzheimer’s disease, and it can be misdiagnosed in patients suffering depression, memory deficits because of normal aging, arterial blockages or even certain vitamin deficiencies. Doctors generally rule out other possibilities, then apply criteria developed by various medical organizations to arrive at the diagnosis.
What stage of Alzheimer’s disease am I in? What comes next?
Clinicians in the United States classify the progressive deterioration of brain function in Alzheimer’s disease into seven stages. By the last stage, patients require round-the-clock care. In the first, second and third stages of this slow moving illness, symptoms are minimal, and many patients work and live independently.
What can I do to preserve my health and mental abilities for as long as possible?
Although there are no treatments to halt or cure Alzheimer’s disease, recent studies have suggested that exercise, a healthy diet and mental stimulation may delay the onset of disabling symptoms.
What physical symptoms should I anticipate?
Patients typically complain of problems with memory and organizational ability, but Alzheimer’s disease also attacks the brain’s motor centers, resulting in problems with balance, coordination, bladder and bowel control, and certain reflexes, including the ability to swallow. Patients and their caregivers should prepare for mental and physical disabilities.
Should I undergo brain neuroimaging?
Imaging of the brain occasionally can help differentiate Alzheimer’s disease from other potential causes of dementia in new patients; however, imaging is rarely useful for determining the severity of the disease.
My children are worried about inheriting this illness. Would it be useful for our family to undergo genetic testing?
Scientists have identified several gene mutations associated with an increased risk of developing Alzheimer’s disease, but the predictive value of each mutation is low. As a result, genetic testing is useful only for individuals who have several close relatives suffering from early-onset forms of the disease.
What drugs are currently available for Alzheimer’s disease, and how well do they work?
Two types of drugs are currently prescribed for treatment of Alzheimer’s disease. Cholinesterase inhibitors, such as donepezil and galantamine, regulate acetylcholine, a neurotransmitter influential in learning and memory. The only NMDA receptor antagonist on the market, memantine, tamps down excessive brain activity. Both types have been shown to delay brain deterioration for a brief period (6 to 12 months) in about half the people treated.
My family is afraid to let me drive. Would you refer me for a driving evaluation so we can have an objective opinion of my ability?
Driving is often a focal point of familial controversy. Diagnosis of Alzheimer’s disease doesn’t always require that a patient immediately stop driving. An objective medical evaluation can be helpful in clarifying the extent of a new patient’s disability.
What can I do to make things easier on my family?
Because Alzheimer’s erodes cognitive ability, it’s important for patients to plan for a day when they can no longer take care of their affairs. Newly diagnosed patients should execute medical and durable powers of attorney that authorize spouses or other family members to deal with banks, insurance companies, doctors and others on their behalf. Reprinted with permission New York Times Syndicate