Alzheimer’s disease can be notoriously difficult to diagnose. In fact, an Alzheimer’s diagnoses cannot be confirmed until after death, when the brain can be autopsied and shown to possess damage on a cellular level. The first problem in achieving diagnoses can be the patient themselves. Patients often attribute the symptoms of Alzheimer’s to simply “getting old,” or in extreme cases, they may be unaware of the changes in their behavior. When a patient does approach their doctor about memory problems, the doctor must sift through all the evidence to determine if Alzheimer’s disease is present, or if it is one of the myriad conditions that produce similar symptoms. Despite the fact that doctors must rule in Alzheimer’s after they have ruled everything else out, diagnoses of the disease are thought to be close to 90% accurate.

The first step a doctor will take in diagnosing Alzheimer’s disease is to take a full patient history and profile. They will need to take into account the patient’s medical history, any relevant family medical history, and any other medical problems the patient is experiencing or for which they are receiving treatment. Next, the physician will interview the patient in detail about the problem that brought them to the office – the level of memory loss, the types of things that are being forgotten, and any other behavioral changes that have accompanied the onset of the memory loss. The doctor will also need to ask questions to determine a patient’s mental state, as diseases such as depression can cause many symptoms similar to Alzheimer’s. To complete the picture, the doctor may also put the patient through a Mini Mental State exam – a short test of problem solving skills, attention span, and counting skills – that can suggest to the doctor if there is damage in any particular area of the brain.

The next piece of the puzzle is the physical exam. The physical exam will include everything from vital signs and weight to reflexes and eyesight. Any abnormalities the doctor finds during the physical exam can lead to uncovering a disorder with symptoms that mirrors Alzheimer’s disease, thereby allowing the physician to rule out Alzheimer’s. The absence of any abnormalities during the physical exam can, on the other hand, signal to the doctor that a diagnosis of Alzheimer’s should not be taken off the table.

A series of lab tests can also be useful in diagnosing Alzheimer’s. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans both allow doctors to see a “picture” of the brain that can flag up other causes of memory loss, such as stroke, or show atrophy or structural changes in the brain that are present in advanced Alzheimer’s. An electroenecephalogy (EEG) analyzes electric activity in the brain and can help a doctor exam various brain functions, such as memory, emotion, and language. EEGs are also useful for ruling out non-Alzheimer’s related memory problems. An electrocardiogram (ECG/EKG) also measures electrical activity, this time in the heart, and is also used to rule out other disorders. A chest X-Ray may also be ordered if a heart/lung problem that might be disrupting blood flow to the brain is suspected.

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