Alzheimer's Disease Information

Alzheimer's disease (AD) or primary dementia of Alzheimer's type is an incurable, degenerative neuropsychiatric disease which results in a pervasive loss of first mental, then physical functioning due to the deterioration of brain tissue. Progressive dementia not due to any external or psychological cause is its primary and most pervasive symptom. Its exact etiology (cause) is still unknown, but is considered to be physiological. Genetic factors are thought to contribute. Certainty of diagnosis still requires autopsy of the brain, to determine the existence of characteristic senile plaques (which while indicators, are not causal factors of the memory loss) within the brain's neuronal structure, the one way to confirm the dementia was not caused by some other illness, substance, injury or disorder.

Diagnosis

The diagnosis is made primarily by clinical observation and tests of memory and intellectual functioning over a series of weeks or months, with various physical tests (blood tests and brain imaging) being performed to rule out alternative diagnoses. No medical tests are available to conclusively diagnose Alzheimer's disease pre-mortem, however.

The intrusion of managed care may complicate the application of adequate testing by doctors who subscribe to its dictums, in the earlier stages. Interviews with family members and/or caregivers can be extremely important in the early phases as well, as the sufferer him/herself may tend to minimize his symptomatology or may be being observed on a day when his/her symptoms are in temporary dormancy.

Initial suspicion of dementia may be strengthened by performing the mini mental state examination, after excluding clinical depression. Psychological testing generally focuses on memory, attention, abstract thinking, the ability to name objects, and other cognitive functions. Results of psychological tests do not easily distinguish between Alzheimer's disease and other types of dementia but can be helpful in establishing the presence of and severity of dementia. They can also be useful in distinguishing true dementia from temporary (and more treatable) cognitive impairment due to depression or psychosis, which has sometimes been termed "pseudodementia".

While expert clinicians who specialize in memory disorders can now diagnose AD with an accuracy of 85-90%, a definitive diagnosis of Alzheimer's disease must await the autopsy.

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