From Medical Evaluations to Questionnaires: Read About the Tools Used To Diagnose Alzheimer’s
Detecting the disease.
Diagnosing Alzheimer’s can’t be accomplished with one single test. And while diagnosing dementia can be relatively straightforward, it’s not always easy to say what the exact cause may be, especially in the earlier stages of AD. A primary doctor, neurologist, or geriatrician may use the following diagnostic tools to help evaluate a patient’s condition.
Medical History and Physical Exam
This is a chance for a doctor to take a thorough medical history, asking about current and past illnesses, diet and nutrition, what medications the patient may be taking, and whether other family members have a history of Alzheimer’s or other types of dementia. The doctor will likely do a medical workup, including listening to the heart and lungs; taking blood pressure, temperature, and pulse; collecting blood and/or urine samples for further testing; and other assessments. This information will be used to help rule out other health issues that may be causing symptoms of dementia, according to the Alzheimer’s Association.
Assessing Mental Status
These tests help to evaluate memory, problem-solving ability, and other cognitive skills.
- Mini Mental State Exam (MMSE): This is a series of questions that help evaluate everyday mental skills. A score of 20–24 out of 30 points indicates mild dementia; 13–20 suggests moderate dementia, and less than 12 indicates severe dementia.
- Mini Cog: This exam can help detect cognitive impairment. The patient is asked to complete two tasks: The first is to remember the names of three common words (such as banana, table, and baby) and repeat them a few minutes later. The second is to draw a face of a clock, showing all 12 numbers in the right places and a specified time.
Imaging technology helps doctors to see if there are structural and functional changes in the brain. Computed tomography (CT) and magnetic resonance imaging (MRI) scans can show shrinkage in the brain; they can also help rule out other issues that might be causing symptoms of dementia, such as a stroke or a nerve injury. MRIs have higher-resolution images and may be used as a follow up for CT scans. Positron emission tomography (PET) and single photo emission computed topography (SPECT) scans are also used to evaluate brain function. While health professionals have outlined predictable patterns of events with these stages, scientists are working hard to develop new medications and create new scenarios that will help AD patients as they move from one stage to another.
Functional Activities Questionnaire
The following questionnaire can be used to assess cognitive impairment in individuals. Ask the caregiver to rate a patient’s ability using the following scoring system:
Requires assistance: 2
Has difficulty but does by self: 1
Never did [the activity] but could do now: 0
Never did and would have difficulty now: 1
- Writing checks, paying bills, balancing checkbook
- Assembling tax records, business affairs or papers
- Shopping alone for clothes, household necessities or groceries
- Playing a game of skill, working on a hobby
- Heating water, making a cup of coffee, turning off stove after use
- Preparing a balanced meal
- Keeping track of current events
- Paying attention to, understanding, discussing TV, books, magazines
- Remembering appointments, family occasions, holidays, medications
- Traveling out of neighborhood, driving, arranging to take buses
Scores are on a scale of 0–30. A score of 9 or higher may indicate impaired function and possible cognitive impairment.
A version of this article appeared in our partner magazine Alzheimer’s: New Hope for a Cure, in 2020.