I read that a neurologist has special tests that can determine if uncharacteristic behavior is due to dementia or some other condition. My husband's neurologist diagnosed my husband with Alzheimer’s disease; however, he did not give him any tests. Are there tests that are routinely given as part of an Alzheimer’s disease evaluation? [ 08/30/13 ]
Physicians can correctly diagnose Alzheimer's disease (AD) about 90 percent of the time based on mental and behavioral symptoms, a physical examination, neuropsychological tests, and laboratory tests. It is possible that your husband's symptoms were so pronounced (to the trained eye) that the neurologist felt confident in declaring an AD diagnosis without further testing. To learn more about the tests that are routinely performed as part of an Alzheimer's disease evaluation, please read the section titled “What are the diagnostic tests used in Alzheimer's disease?” under Frequently Asked Questions (FAQ).
How long does Alzheimer's disease last on average? [ 08/30/13 ]
On average, patients with Alzheimer's disease live for 8 to 10 years after diagnosis. However, this terminal disease can last for as long as 20 years.
Is Alzheimer's covered by Medicare/Medicaid? [ 08/30/13 ]
Medicare is a federal health insurance program for people age 65 or older who receive Social Security retirement benefits. To receive assistance from Medicare, a person must meet specific eligibility requirements. Medicare covers some, but not all, of the services a person with Alzheimer's disease may require. For example, the program does not cover long term healthcare. Medicaid is a federal program for certain individuals and families with low incomes and resources, typically administered by state agencies; eligibility and benefits vary from state to state. Medicaid can cover all or a portion of nursing home costs. A person with Alzheimer's can qualify for long term care only if there are minimal income and cash assets. Medicaid may be applied for by calling each state's Department of Human Services or Medicaid Assistance Program.
Who should I go to if I suspect I may have Alzheimer's disease? [ 08/30/13 ]
First, visit your regular family physician. The physician will probably do a variety of tests to determine the probability of Alzheimer's. Specialists such as neurologists, gerontologists and geriatric psychiatrists may also be involved in the evaluation process.
How is Alzheimer’s disease diagnosed? [ 08/30/13 ]
While an autopsy can confirm the presence of the disease, skilled physicians can correctly diagnose Alzheimer's disease about 90 percent of the time based on mental and behavioral symptoms, a physical examination, and neuropsychological and laboratory tests. Scientists have recently developed a number of new biomarker and brain scanning techniques that may help to improve diagnosis.
Mentally, having trouble following instructions, losing one's orientation, displaying poor judgment, and having difficulty managing money, shopping, or driving are all possible symptoms of Alzheimer's disease.
The physical exam will usually include a general physical, blood tests, and urinalysis. The doctor can use such test results to eliminate other forms of dementia—for instance, certain vitamins and hormones can provoke symptoms of dementia if they are present in too little a quantity. Brain scans can rule out non-Alzheimer's disease dementia and can reveal structural changes present in Alzheimer's disease.
The physician will determine whether neuropsychological testing is called for to examine memory, attention, math calculations, language and other intellectual functions.
The place to start is with one's own physician, who may then suggest specialists to do further testing.
Are there treatments available for Alzheimer’s disease? [ 08/30/13 ]
Yes, while there is no cure for Alzheimer's disease as yet, there are medications that can help control its symptoms and to help manage conditions such as agitation, depression, or psychosis (hallucinations or delusions), which may occur as the disease progresses:
Cholinesterase inhibitors: People with Alzheimer's disease have low levels of a key nerve messenger, called acetylcholine, believed to be important for memory and thinking. Four drugs called cholinesterase inhibitors make more of that messenger available by slowing its breakdown, enabling greater cell-to-cell communication and slowing the progress of cognitive impairment in some patients with early- to middle-stage Alzheimer's disease. The four cholinesterase inhibitors are:
- Razadyne® (galantamine)
- Exelon® (rivastigmine)
- Aricept® (donepezil)
- Cognex® (tacrine)
All four have been approved by the Food and Drug Administration (FDA) for early- to middle-state Alzheimer's disease; Aricept® is also approved for severe-stage symptoms. Cognex® was the first approved cholinesterase inhibitor but is rarely prescribed today due to safety concerns.
Namenda® (memantine) The first FDA-approved drug for moderate to severe Alzheimer's disease, Namenda is thought to protect brain cells by regulating a nerve communication chemical, called glutamate, that is released in great quantities by Alzheimer's-damaged cells. Glutamate is normally involved with learning and memory, but when released in excess by damaged cells, it attaches to “docking sites” called NMDA receptors that in turn accelerate cell damage.
Treatment for mental illnesses People with the later stages of Alzheimer's disease often experience depression, agitation, paranoia, delusions, and/or hallucinations, which can in turn cause screaming, repetitive questions, hoarding, pacing, hyperactivity, and aggressive behavior.
These symptoms can arise from non-medical triggers as well as medical causes. The former could take the form of a change in the person's environment (a new place to live, a new caretaker, a change in routine) or from frustration at the inability to communicate. If the trigger can be identified, the environment can be modified to change the behavior.
If non-medical intervention doesn't work, or the patient becomes a danger to himself or others, a physician should be asked to evaluate the need for medical treatment.
Sources for financial assistance for Alzheimer's disease prescription drugs can be found at www.brightfocus.org/alzheimers/resources/alzheimers-disease.html. Always consult a physician before taking any medications.
Are there drugs that can delay the onset of Alzheimer's disease? [ 08/30/13 ]
Aricept (donepezil), an Alzheimer's disease treatment appears to have a slowing effect—though limited—on the progression from mild cognitive impairment (MCI) to Alzheimer's disease, according to a study published in April 2005 by the New England Journal of Medicine. Those with MCI, such as the study participants, experience memory problems, but are able to function independently; however, MCI is often a transitional stage that leads to the serious cognitive decline of Alzheimer's disease. Over the first year of the three-year trial, MCI patients treated with Aricept had a reduced risk of progressing to Alzheimer's disease compared to patients who took a placebo, an inactive pill. The study found the effect of the Aricept treatment lasted longer (up to two to three years) in those patients carrying the ApoE4 gene. Previous studies have shown that those with the ApoE4 gene have a higher risk of developing Alzheimer's than the general population. Source: Mayo Clinic, Rochester and the National Institute on Aging
Is there a correlation between aluminum and Alzheimer's? Does coffee drinking increase the risk of developing Alzheimer’s disease? [ 08/30/13 ]
There is some evidence to causally link aluminum to Alzheimer's disease, however, further studies need to be done to definitely establish that high levels of dietary aluminum lead to Alzheimer's disease. You can read more about the connection between aluminum and AD in the frequently asked questions (FAQs) section of our website.
As far as coffee goes, recent studies indicate that there may be a beneficial effect to consuming caffeine. For example, in one study it was found that the prevalence of Alzheimer's disease and dementia was lower in people who consume on average one cup of coffee per day compared to those who do not regularly drink coffee. Another study investigated the effects of caffeine in a mouse model of Alzheimer's disease (Arendash et al. Neuroscience. 2006; 142(4): 941-952). Researchers found that giving the mice 1.5 mg of caffeine per day in their drinking water (which is the human equivalent of about five cups of coffee per day) caused the mice to perform significantly better on several behavioral and cognitive tests than their non-caffeine consuming counterparts. Additionally, the investigators found that long-term administration of caffeine to these transgenic mice resulted in lower brain levels of amyloid beta protein, which is the protein responsible for much of the pathology (e.g., amyloid plaques) characteristic of Alzheimer's disease. However, because of the negative side effects associated with the overuse of caffeine (heart palpitations, anxiety, nervousness, headaches, peptic ulcers, etc.) it generally not advised that anyone should start drastically increasing their coffee intake.