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Alzheimer’s Test Guide: How to Diagnose Alzheimer’s Disease

As you age, the need to ensure your brain stays active and sharp is just as critical as ensuring your body stays in peak condition. That’s why it’s super important to learn key facts about testing for Alzheimer's and the benefits of early detection for a long-term prognosis.

Changes in memory and cognition have always been a natural part of the aging process, and it’s easy to confuse these with the typical signs of dementia. In truth, Alzheimer’s tends to progress very slowly and is barely detectable in its earliest stages. It can be divided into four parts: 

  1. Preclinical
  2. Mild or early-stage
  3. Moderate
  4. Severe or late-stage

The first, or preclinical, phase can start as much as a decade before any real symptoms appear and involves specific chemical reactions in the brain.

Since symptoms manifest differently (and slowly) in each person, diagnosing Alzheimer’s requires a whole battery of tests. Over time, memory and cognitive problems become increasingly noticeable. Individuals experiencing stage two of Alzheimer’s still seem like themselves on the outside. However, their perception of the world has begun to shift ‒ making it a strange and confusing place. Accepting this shift is extremely difficult both for the patient and their loved ones. 

Consider consulting your health care provider and taking an early Alzheimer’s test if you observe any symptoms of mild Alzheimer’s, such as:

  • Memory problems
  • Poor decision-making and discernment
  • Lack of interest in activities 
  • Trouble completing tasks in a timely manner
  • Asking the same questions repeatedly
  • Difficulty managing personal finances 
  • Wandering and getting lost
  • Losing or leaving objects in odd places
  • Emotional and character changes
  • Anxiety and/or aggression

As the disease advances to phase three, or moderate Alzheimer’s, the patient’s memory and cognition become further impaired and they may need round-the-clock care. If a test for Alzheimer’s has been conducted and a diagnosis confirmed, talk to family members and caregivers about creating an action plan. Note that the signs of moderate Alzheimer’s disease include:

  • Inability to learn new tasks
  • Trouble with language, reading, writing, and simple arithmetic
  • Impaired logic 
  • Poor concentration
  • Adverse reactions to new objects and environments
  • Trouble completing routine tasks like getting dressed
  • Difficulty recognizing family and friends
  • Hallucinations, delusions, and paranoia
  • Impulsive and inappropriate behavior
  • Anger issues
  • Anxiety, restlessness, and strong emotions
  • Desire to wander in the late afternoon or evening
  • Repeating phrases or actions
  • Muscle twitches

It may be necessary to admit those with severe or stage four Alzheimer’s disease to a medical facility delivering comprehensive care. Late stage dementia is usually marked by:

  • Poor communication skills and speech
  • Weight loss 
  • Seizures
  • Skin problems
  • Trouble swallowing, which could trigger aspiration pneumonia
  • Groaning, moaning, or grunting
  • Excessive sleeping
  • Incontinence

Unfortunately, there is no known cure for this condition, but your health care provider could prescribe medications to help treat some of its symptoms.

Although it’s known as a disorder predominantly affecting the elderly (i.e., 65 or older), individuals as young as 30 can develop Alzheimer’s. In fact, the likelihood of getting it doubles every five years, and as much as one-third of people over 85 are diagnosed with it. That’s why it’s absolutely critical to know how to test for Alzheimer’s. 

Experts say that genetics can play a significant role in determining susceptibility to Alzheimer’s. So think about researching your family’s medical history and whether any close relatives had the disease. 

Whether it’s early-onset or late-onset Alzheimer’s (more commonly found in those over 65), evidence of certain changes have been detected on chromosome 19. In the latter type of Alzheimer’s, this genetic risk factor is known as APOE ɛ4. The scientific correlation here is far from perfect, though, as some will inherit the gene but never struggle with dementia. On the other hand, some patients who are diagnosed with Alzheimer’s do not even possess the gene. 

Roughly 10 percent of the population, ages 30 to 65, will get early-onset Alzheimer’s because they carry one of three inherited genes:

  1. Amyloid precursor protein (APP)
  2. Presenilin 1 (PSEN1)
  3. Presenilin 2 (PSEN2)

Of course, additional research is needed to discover if any other genetic factors contribute to early-onset Alzheimer’s. Also, keep in mind that diagnosing Alzheimer’s through genetic testing is intended for early-onset (not late-onset), particularly if you’ve discovered a family history of it.

Diagnosing Alzheimer’s requires a clinical examination of physical symptoms and prior medical history. Guidelines for a standardized Alzheimer’s test are supplied by the National Institutes of Health-Alzheimer’s Disease and Related Disorders Association (NIH-ADRDA). 

Alzheimer’s disease testing is initially based on memory and cognitive impairment, then relies on brain imaging technology, such as CT, MRI, and PET scans. In conjunction with other labs, these results rule out alternative causes of dementia, like cerebrovascular or thyroid disorder, B12 deficiency, or syphilis.

There are many things to take into account once you’ve decided to go through with an Alzheimer’s test. The evaluation process is composed of several aspects and likely includes the following:

The progression of Alzheimer’s over the course of a decade or so will affect behavior and language capabilities, as well as visual and spatial awareness. Patients often find routine tasks that require planning and problem-solving to be quite challenging. 

As it’s difficult to spot the signs of dementia in yourself, providers ask spouses or children to inform them of such changes. An early Alzheimer’s test might therefore require the family member to help list symptoms and provide examples of behavioral adjustments. Even then, Alzheimer’s symptoms are tough to zero in on because humans naturally adapt and function under new circumstances.  

Testing for Alzheimer’s also gauges the ability to carry out basic activities of daily living (BADL), such as eating and grooming. Chores like paying bills and handling money are thought of as instrumental activities of daily living (IADL).

To eliminate other forms of dementia and confirm what stage the disease is in, a neurological and mental status exam will be done. The first part of these physical tests for Alzheimer’s focuses on: 

  • Attention and concentration
  • Recent and remote memory
  • Language skills
  • Completion of goal-oriented tasks
  • Executive function
  • Visual/spatial awareness

Symptoms of early cognitive impairment related to Alzheimer’s include memory decline, loss of words, and communication problems. This is typically accompanied by a lack of self-awareness in relation to surroundings and nearby  objects. In the long run, testing for Alzheimer’s means following up on these issues at each visit. Your health care provider is going to monitor how quickly it’s progressing and note differences in memory or cognitive function. 

Standardized testing for Alzheimer’s is recommended based on the patient’s unique symptoms and which phase they’re currently in. For example, there’s the Montreal Cognitive Assessment (MoCA) and the Saint Louis University Mental Status (SLUMS) protocol. Or, in some cases, it might be useful to run an Alzheimer’s peanut butter test to check their sense of smell. Lastly, a thorough neurologic Alzheimer’s test is conducted to exclude other types/triggers of dementia, like Parkinson’s disease or stroke.

Brain scans reveal visible differences in the brain, along with underlying conditions like stroke, trauma, or a tumor. While MRIs and CTs do show diffuse cortical and/or cerebral atrophy, it’s not a definitive way to test for Alzheimer’s. New technology is currently undergoing clinical trials to locate damage sustained by the brain due to the onset of Alzheimer’s.

The American Academy of Neurology (AAN) established guidelines for understanding the root causes behind cognitive impairment through the process of elimination. They allow medical experts to check for cobalamin (or B12) deficiency and assess thyroid function. Extra tests may be required depending on symptoms and medical history. This includes searching for hematologic, liver, or autoimmune disorders, infectious diseases, and vitamin D deficiency.

Understanding the process of how to test for Alzheimer’s and which warning signs to take note of will aid in the early detection of dementia. If you’re concerned about memory loss or seem to be experiencing cognitive issues, please make an appointment to take the Alzheimer’s test.

National Institute on Aging (NIA), National Institutes of Health; May 16, 2017

National Institute on Aging (NIA), National Institutes of Health; December 24, 2019

Medscape: Alzheimer Disease Clinical Guidelines; May 9, 2019.

Medscape: Alzheimer Disease Physical Examination; May 9, 2019

Medscape: Alzheimer Disease Clinical History Examination; May 9, 2019

Mayo Clinic: Alzheimer’s Disease Diagnosis; Dec 8, 2018.

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