Diagnosing Dementia

If Alzheimer’s disease is, as yet, incurable, what is the use of getting yourself or a family member diagnosed?

“Early diagnosis is in fact, even without a treatment, very important,” says neurologist Allan Levey, director of the Goizueta Alzheimer’s Disease Research Center at Emory. About 1,000 people a year come to the center to be evaluated for the disease.

About 5.7 million Americans age 65 or older are living with Alzheimer’s or related diseases. By 2060, it is estimated that will increase to 13.9 million Americans. Risk factors: age, genes, head injury, vascular disease, diabetes, hypertension, or high cholesterol, sedentary lifestyle. Factors that might reduce the risk: exercise, healthy diet, mental stimulation, and control of high blood pressure, heart disease, and diabetes. Alzheimer’s is the most expensive disease in America, costing $18 million an hour. The costs to families and society total more than $277 billion a year, with Medicare and Medicaid picking up the vast majority of expenses.

Most Americans living with Alzheimer’s—or related dementia disorders—never receive a diagnosis, and even if they do it is usually several years into the illness since memory loss is often seen as a normal part of aging.

Early diagnosis allows someone to:

- make their choices for the future known, before the disease progresses

- put financial and legal plans into place and draw up and sign legal documents

- decide on living arrangements for now and the future, with increased levels of assistance

- reduce the chance of elder abuse

- avoid unnecessary hospitalizations and procedures.

Patients are encouraged to first see a primary care physician for a medical exam, blood work-up, and a simple memory screening. This physician can determine if the patient’s memory loss is due to Alzheimer’s or another condition, such as a vitamin deficiency or improper medications.

At the Goizueta Alzheimer’s research center, or one of five satellite centers, doctors review patient symptoms, changes in symptoms, past medical conditions, and family history. The patient will have another physical examination, possible blood work, a memory assessment, and a brain scan. If a diagnosis of Alzheimer’s is made, the doctor, patient, and patient’s family sit down to come up with a treatment plan.

Patients can volunteer to participate in clinical trials and patient registries. A network of NIH-funded Alzheimer’s disease research centers, including Emory’s, is working to find a treatment for the disease.

“Ideally, we would be able to prevent it, and the first prevention trials are under way,” says Levey, chair and professor of neurology at Emory. “We’re trying to develop the next generation of biomarkers that can improve diagnosis to see if we can slow down or prevent the disease.”

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