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Home > Medical Reference > Patient EducationServices at Maryland GeneralA complete list of inpatient and outpatient healthcare services at MGH.Alzheimer's disease - DiagnosisDescriptionAn in-depth report on the causes, diagnosis, and treatment of Alzheimer's disease.Alternative NamesAD Diagnosis:Alzheimerâ ' s disease can only be definitely diagnosed after death when an autopsy of the brain is performed. However, doctors use a variety of tests to make a probable diagnosis of Alzheimerâ ' s. Medical History and Physical ExaminationThe doctor will ask questions about the patientâ ' s health history, including other medical conditions they patient has, recent or past illnesses, and progressive changes in mental function, behavior, or daily activities. The doctor will ask about use of prescription drugs (it is helpful to bring a complete list of the patientâ ' s medications) and lifestyle factors, including diet and use of alcohol. The doctor will evaluate the patientâ ' s hearing and vision, and check blood pressure and other physical signs. A neurological test will also be conducted to check the patientâ ' s reflexes, coordination, and eye movement. Laboratory TestsBlood, urine, and possibly spinal fluid samples are collected. They can help the doctor evaluate other possible causes of dementia, such as thyroid imbalances or vitamin deficiencies. Neuropsychological TestsA number of psychological tests are used to assess difficulties in attention, perception, memory, language, and problem-solving, social, and language skills. These tests can also be used to evaluate mood problems such as depression. One commonly used test is the Mini-Mental State Exam (MMSE), which uses a series of questions and tasks to evaluate cognitive function. For example, the patient is given a series of words and asked to recall and repeat them a few minutes later. In the clock-drawing test, the patient is given a piece of paper with a circle on it and is asked to write the numbers in the face of a clock and then to show a specific time on the clock. Brain-Imaging ScansImaging tests are useful for ruling out blood clots, tumors, or other structural abnormalities in the brain that may be causing signs of dementia. These tests include magnetic resonance imaging (MRI) or computed tomography (CT). Functional and volumetric MRIs, as well as positron-emission testing (PET) scans, have some ability to predict the future course of early Alzheimer disease. However, they are often not as good or no better than clinical exam and history in predicting the course of this disease Ruling out Other Causes of Memory Loss or DementiaAlzheimerâ ' s disease is the most common cause of dementia. However, other causes of dementia in the elderly can include:
Vascular Dementia. Vascular dementia is primarily caused by either multi-infarct dementia (multiple small strokes) or Binswanger's disease (which affects tiny arteries in the midbrain). Lewy Bodies Variant. Lewy bodies are abnormalities found in the brains of patients with both Parkinson's disease and Alzheimer's. They can also be present in the absence of either disease; in such cases, the condition is called Lewy bodies variant (LBV). In all cases, the presence of Lewy bodies is highly associated with dementia. Parkinson's Disease. Some of the symptoms of Parkinsonâ ' s disease and Alzheimerâ ' s can be similar and the diseases may coexist. However, unlike in Alzheimer's, language is not usually affected in Parkinson's related dementia. Parkinson's disease is a slowly progressive disorder that affects movement, muscle control, and balance. Part of the disease process develops as cells are destroyed in certain parts of the brain stem, particularly the crescent-shaped cell mass known as the substantia nigra. Nerve cells in the substantia nigra send out fibers to tissue located in both sides of the brain. There the cells release essential neurotransmitters that help control movement and coordination.  Frontotemporal Dementia. Frontotemporal dementia (FTD) is a term used to describe several different disorders that affect the frontal and temporal lobes of the brain Although some of the symptoms can overlap with Alzheimerâ ' s, people who develop this condition tend to be younger than most patients with Alzheimerâ ' s disease. Other Conditions. A number of conditions, including many medications, can produce symptoms similar to Alzheimer's. These conditions include severe depression, drug abuse, thyroid disease, vitamin deficiencies, blood clots, infections, brain tumors, and various neurological or vascular disorders. Resources
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