How does the doctor know it's Alzheimer's and not dementia?

booksme - You are welcome. I am a novice with all of this myself! UGH! Fortunately, my Mom has a great doc. He is very thorough and so, so considerate. He is helping me however he can with trying to get my siblings to see the need to place her or at the least, greatly increase her in home care. We are all learning together. And for me, sites like are a big help, because I can't talk to my siblings about her - they don't want to hear the truth. My brother just recently said I was becoming one serious "B****", because I told him the truth about the situation again and that my sister needed to do more. Unbelievable. We have nothing to talk about any longer outside of Mom's care. Between her and my son - I am bonkers!

Thanks for replying. I am learning that this is an ongoing process, with no answers set in stone, so to speak.

mslynne - (((HUGS))) I know this is all so scary and extremely frustrating. Maybe the doctor isn't doing more tests at the moment because he needs to rule out certain things before more action is taken. My Mom's tests were not all together - they were several weeks and months apart. We didn't get the MRI to DX vascular dementia until a couple of months later. Ask the doc what his suspicions are and how he is going to proceed if that doesn't pan out. He should tell you, should be up front with you. If he won't cooperate and keep you informed, find another doc ASAP.

The psych drugs could be playing a part, and the doc wants to rule that out first. My son's psych drugs caused kidney damage and he had to completely change meds , regressed and just now after 6 months reached stability again.

I see it now...not the first one but my one asking where my post is. Where did it go? what mri can show blood flow? My daughter is about to get an MRI...if something needs to be added to it for more diagnostic information I'd like to know now Thanks.

I posted a question. I don't see mine or any replies. I gave my email address. No replies there either. I'm confused. Where is my post?

My daughter is scheduled for a regular MRI. Insurance will not pay for 2. I'm confused about the comments here. The doctor is a board certified psychiatrist and also neurologist. He's from the Mayo. Why isn't he asking for these extra tests? My daughter has horrible memory loss...short term mostly. The current psych doctor is blaming it on something physical so asked this doctor to check out the physical....however this doctor is guessing it's her psych meds. Awaiting tests but need to know how can I get extra tests ordered from him to cover ALL of these things/possibilities one time? Thank you. Thanks. I need help here. So busy I my not make it back here to this site. Thank you.

Luvmymom i totally agree that home family care is the best. We are fortunate to be able to do so but it's not an option for everyone. I hope i can continue to keep my mom and dad home until the end as well and i wish everyone the best in all the very hard and heartwrenching choices that need to be made

luvmymom333: Then your father was a rare example! My response was just for the mainstream Alzheimers' patients.

Dear luvmymum333, that was a heart warming account of you looking after you dad gor 5 years with alzheimers.
How did you distinguish 'end stage'? And how long did it last?

Dear Llamalover- Took care of my father with Alzheimers at home for 5 years before his passing. He was constantly losing things and looking for them. But he definitely knew what was his, and what wasn't. Even when he shouldn't have been driving, he knew which key to put in the ignition, and even had extras when mom hid his. I think maybe this varies from person to person. The doctor said he lived a long time in the end stage, he would call him the man with 9 lives! lol It was so hard keeping him home, especially for my mom. But I wouldn't have changed it for the world. I have a warm feeling in my heart knowing we did the best we could for him. Even the grandkids bathed and dressed him. They never looked at it as a chore, they saw it as their responsibility. Wish all families could pull together and keep the older family members at home. I think they live longer. :)

This is for crickett33 - I am sure that you requested the testing? My Mom's doctor first just did a questionnaire type test. I would ask again. Take documentation - a daily diary of what occurs. Take video if you can do it discretely. If he still won't do it, then request a referral to a neuro doc or find a new doctor. If he has seen the cognitive decline, then, if he's worth his salt, he should do the preliminary testing. ((HUGS))) This is so hard. The doctor should know that what your Mom needs must come before all else.

xxxxxxxx: I disagree! E.g. a dementia patient loses their keys, but if found, knows they are certainly his/her vehicle keys. An Alzheimer's patient looks at the keys sitting right in front of him/her, but has to recollection or "connection" as to what they are for, sadly.

Two things: How to explain dementia to a layperson, and the Lewy Body Dementia web site for excellent questions and answers with personal experiences.
When I try to explain dementia to a layperson, I ask them to imagine an umbrella. The top of the umbrella (the metal tip) is dementia. The metal spines that extend from that to help support the material of the umbrella are different types of dementia, for example Alzheimer's Disease, Lewy Body, Frontal Lobe. Obviously, I would need more spines to be entirely accurate, but this helps the person understand and explain it to others. I think the main point in that Alzheimer's is A dementia, not THE dementia. I've heard, "He has dementia but thank God it isn't Alzheimer's", and this would be a good example of when to mention the umbrella.

Secondly, I'm a huge advocate of educating individuals on Lewy Body Dementia. My father died of LBD in 2012. As a gerontologist, I saw the beginnings of dementia, but didn't suspect LBD until more signs appeared. The the layperson, the easiest way for me to explain it would be to say it's almost as if indications of both Alzheimer's Disease and Parkinson's exist in the same person. Then I go on to explain in more detail, should they be interested. Please google Lewy Body Dementia Association. They have a fantastic web site with questions and answers and you can participate whenever you like.

I highly recommend a book written by a leading neurologist, "The Myth of Alzheimer's." There will never be a cure for Alzheimer's. In the "good old days" t was referred to as "hardening of the arteries." A must-read for every caregiver; in fact, the truth will set you free in a way that will make you feel about what you're doing in another dimension.

I've had that same question about my mom. She refuses to go to the doctor for more than blood pressure pills, pain pills and xanax. She won't even consider a neurologist or geriatric specialist. I tried to sneak her in one time for a checkup with an expert and the doctor's office went and sent her a letter informing her of the upcoming visit, which I'd asked them not to do. My plan was to say "oh let's go to this health fair and get free samples and a massage" and they blew my cover. Now she won't participate with anything. In fact, and she has some mental illness issues, she won't cooperate with me on anything. Her neighbors drive her around, and I gave up. I figure I'll hear from her when she's on the other pole where she doesn't think I'm plotting against her.

How does one convince the doctor to 'run the tests' when the doctor, himself, notices cognitive differences - even if it's only "forgetfulness?" Mom's such a charmer, charismatic with others: she's adept at getting the doc to talk about himself!. So i go home, living w/mom and i'm the whipping post that gets the mood swings, hit, cussed at, belittled/demeaned and so on. But the doc claims "she doesn't exhibit the signs" ... but oh, my, if only they followed me outside -- even to the waiting room. How do i enforce the testing? i had to BEG for a pill to get her ready for her surgery - and finally he consented to xanax [#20 only]. i want that "magic pill" that at least slows things down. Thank you.

my mother went to a neurologist...and he told us...symptoms are mixed...dementia, Alz, and Parkinsons...all part of the disease.

Alzheimer's is a type of dementia, and no matter what name it is called, a definitive name can only be learned at an autopsy.

Here is a way that scans can be more definitive in diagnosing alzheimers.

A new type of brain scan may help to detect Alzheimer’s early, using no radiation and at less cost than other techniques, researchers report. Doctors at the University of Pennsylvania’s Perelman School of Medicine have developed a form of magnetic resonance imaging, or MRI, that detects brain changes that signal Alzheimer’s disease. The doctors have developed a modification to the technique called arterial spin labeling, or ASL-MRI. Small studies show, this may be a useful way to diagnose probable early dementia.

MRI scans are routinely used in hospitals to check for tumors and other issues, and seniors with memory problems may undergo the procedure to rule out brain tumors, strokes or other problems that may be causing the deficits. If Alzheimer’s is suspected, they may then undergo another scanning procedure, such as a PET scan.

The advantage of the new ASL-MRI technique is that someone could undergo brain scanning in a single session to help determine whether Alzheimer’s may be present. The technique looks for changes in blood flow and the uptake of blood sugar, or glucose, in the memory centers of the brain. It requires about an additional 20 minutes compared to standard MRI scans.

“Increases or decreases in brain function are accompanied by changes in both blood flow and glucose metabolism,” explained Dr. John Detre, professor of Neurology and Radiology at Penn, who has worked on ASL-MRI for the past 20 years. “We designed ASL-MRI to allow cerebral blood flow to be imaged noninvasively and quantitatively using a routine MRI scanner.”

Studies show that the MRI method is similar in effectiveness to current PET scans that inject a radioactive dye to measure these brain changes. However, the ASL-MRI method uses no radiation and costs one-fourth as much.

“If ASL-MRI were included in the initial diagnostic work-up routinely, it would save the time for obtaining an additional PET scan, which we often will order when there is diagnostic uncertainty, and would potentially speed up diagnosis,” said Dr. David Wolk, Assistant Director of the Penn Memory Center and a collaborator on the research.

The studies compared the MRI technique and the specialized PET scan results using flurodeoxyglucose, or FDG, a radioactive tracer. In one, published in the journal Alzheimer’s and Dementia, doctors compared images from 13 patients diagnosed with Alzheimer’s and 18 age-matched controls. Both methods proved equally effective in detecting signs of early Alzheimer’s. In the second study, published in the journal Neurology, data from 15 AD patients were compared to 19 age-matched healthy adults. The patterns of reduction in cerebral blood flow were nearly identical to the patterns of reduced glucose metabolism by the PET scan and showed reductions in brain gray matter typical of Alzheimer’s disease.

“Given that ASL-MRI is entirely noninvasive, has no radiation exposure, is widely available and easily incorporated into standard MRI routines, it is potentially more suitable for screening and longitudinal disease tracking than FDG-PET,” said the Neurology study authors.

I agree with Salisbury. Mom's doctor did a whole battery of tests before he made the preliminary DX. His first impression was alzheimer's, but after a time, he amended it to vascular dementia. Mom wasn't progressing at the same rate that an alzheimer;s sufferer would. The two have the same symptoms, just a bit different timeline. To verify that DX, he did a brain scan on top of further blood testing. Every time she goes in for a 3 month dementia checkup, he does a cognitive test -repeating words, spelling words backwards, questions.

Her doc doesn't have much confidence in the meds used to stall progression. He says they help in so few cases. Mom tried Namenda, but it was too late for it to have any real affect. Insurance wouldn't pay for Aricept - it was too expensive, but, it probably wouldn't have helped her much anyway.

Some of the behaviors and missing skills that the neurologist looks for are impaired judgment and decision-making skills, lack of interest in formerly enjoyable events and activities,and changes in personality. Short term menory loss, general depression and advanced age are often first diagnosed as "some sort of dementia."

I have to agree with Salisbury since unfortunately the result may be futile. My mom definitely has dementia. I don't know the form but ruled out the other things mentioned. Our focus is on how to deal with it and the depression that accompanies the dementia. So far meds have had an adverse affect not to say it doesn't help others.

Rather than to try to get an exact definition, it might be easier to :

1. make sure that all other possibilities are exhausted (as in a urinary tract infection, vitamin deficiency, etc), and

2. plan survival strategies, life strategies.

I never got a definitive diagnosis for my mom but I sure knew something was wrong.

Alzheimer's is like your brain is a puzzel and peices disappear slowly never to return leaving holes and dementia is like the puzzle peices of the brain all get mix up the electors miss fire I am sure I have that.mixed up but both can be upsetting and dangrouse to the person with it

Our primary doc said he thought mom had some dementia long before we noticed more then the forgetfulness. He then sent us to a neurologist and he said alz. Few years later he then said it was Lewy body because she was presenting with more classical signs of that type then Parkinsons was diagnosed. My advice to you is to write down any and all things not usually done or used to do that you notice. My opinion, the doctors can only accurate diagnose from what you tell them and unfortunately our loved ones are not able to communicate those things. This site has people on it who have had every type and could be of some help to you. Good luck

Dementia is an umbrella term covering Alzheimer's, vascular dementia, Lewy body dementia, frontotemporal and others. All are cognitive disorders that usually have symptoms that, through office tests and often brain scans, a neurologist can diagnose. New tests for the future will include blood tests and saliva tests. A spinal fluid test is sometimes available but I'm not sure that it's covered by any insurance at this time.

There are many misdiagnoses. Additionally, people can have more than one type of dementia. People with Parkinson's often develop dementia. People with vascular dementia may also have Alzheimer's.

So, yes, it's complicated. Even the best doctor can be wrong. However, diagnosis is getting better. The problem is that there is, at this time, no treatment for most types of dementia. There are drugs that can be used for Alzheimer's that may - and the key word is may - slow symptoms for a time in some people.

The Alzheimer's Association does a good job of explaining symptoms but in the end working with a good neurologist will likely give you the best answer.
Take care,
Caro

Alzheimer's Disease is one of many dementia. He checked symptoms and did some tests that gave him an idea. Unfortunately, you can only tell exactly which form after death, with a brain autopsy.

You really need to know correct dementia diagnosisAlzheimer's disease and dementia, there is a distinct difference, other dementias: Vascular dementia, Parkinson'sdisease, dementia with Lewy Bodies and Frontotemporaldementia. Some causes of dementia aretreatable and evenreversible. source: Mayo Clinic tinyurl/qdgj9g

I gather Information from many resources and here are,
Examples of Dave Mainwaring's Knowledge Networks

My father also had alzheimers. Its true they cannot be certain until after autopsy. But if an mri is done they find the brain to have lesions in the alzheimers patient. You have to be very careful that what they are being treated for is alzheimers. Many patients develop symptoms that mimic it from a uti. These patients can act very psychotic and have dementia symptoms. And doctors seems to readily give these meds before ruling everything else out and can be harsh and if stopped can make patient worse than before starting. I speak from experience. Another thing to check is B12 levels. Older adults can't simulate this vitamin in their stomach many needs shots. (Should have on sublingual B12 vitamins anyway) Knew of an elderly woman put in home bc of dementia symptoms after receiving B12 shots was back to normal and able to live on her own again. Don't get me wrong meds for alzheimers can be a godsend and the earlier started the better. Not a cure but can slow patients progression way down. Hope this helps some:)

I was in nursing for 25 years,my mother had a diagnosis of dementia.I now live in with Alzheimer's/dementia patients.The latest patient mild dementia.So much alike are the two,in different stages,very hard for any physician to ascertain.Wish I had an intelligent answer but I don't.

Alzheimer's Disease is one of many dementias. He checked symptoms and did some tests that gave him an idea. Unfortuanately, you can only tell exactly which form after death, with a brain autopsy. On this site, and on the Alz.org site are checklists of symptoms and definitions of the various stages of what you might expect. Know that every person travels their own path and there's no way to know exactly what is going to happen or even when or if.