Dear Carol: Can they really diagnose Alzheimer's disease? My mother is 74, often confused and gets anxious. She just doesn't seem herself. Her physician sees no evidence of a stroke. She's generally healthy. I've read where Alzheimer's can only be diagnosed after death, and there isn't much you can do if you have it. What's the latest? - Jen
Dear Jen: Alzheimer's and other dementias are frightening to the victim and agonizing for the caregiver. Since there is, so far, no cure, it's hard not to wonder if diagnosis even matters. But a great deal of research is being done and progress has been made. Dr. Pat Konewko, the Clinical Director of the MeritCare Alzheimer's Disease and Related Disorders Program, helps lend some hope and clarity to the issue with his answer below:
"Alzheimer's disease is a specific type of dementia with a recognizable history and set of problems. The term dementia simply means that there has been some change in a person's cognitive functions (e.g. memory, language, functional skills) and/or behavior and personality. Your mother's 'confusion' may be a symptom of an underlying dementia of some type. Psychiatric symptoms of anxiety and depression are very commonplace and may reflect her inability to understand and cope with the world. Dementias in general, and Alzheimer's disease in specific, can be diagnosed with a high level of confidence.
"If your mom has had a complete physical including blood and urine laboratory tests to make sure there are no acute or subacute medical problems, and there aren't any medications that could be causing her confusion, she needs to undergo a more specialized evaluation to determine the basis of her confusion.
"Typically this includes a neurological examination, neuroimaging (e.g. computerized tomography or magnetic resonance imaging of the brain) and neuropsychological tests. The latter involve various tests of memory, language, problem solving and more.
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"An extremely important part of the examination process includes interviews with family and caregivers whenever possible to learn about the person's personality, education, work history and previous level of functioning. This information helps the doctor gauge how much decline in functioning has occurred, if any.
"The treatments currently used help control the symptoms of dementia, including the psychiatric problems. Behavioral and environmental strategies are also utilized, depending upon the nature, extent and severity of problems."
Also, Jen, be sure to check the National Alzheimer's Association Web site at www.alz.org or call the help-line at (800) 272-3900. While you're talking with them, ask about support groups in your area. Best of luck. You aren't alone.
Bursack is the author of a support book on family elder care.
To submit questions to "Minding Our Elders" and view past columns, go to www.in-forum.com and click on Columnists. Readers can reach Bursack at cbursack@forumcomm.com or write her at The Forum, Box 2020, Fargo, ND 58107.
