How Is Alzheimer’s Disease Diagnosed and Treated? (video)

Forgetting a name or misplacing your keys occasionally is usually a normal part of getting older. When changes in memory or thinking begin to interfere with everyday life, however, it may be time to talk with a doctor about the possibility of Alzheimer’s disease.

Understanding the symptoms of Alzheimer’s disease and seeking evaluation early can help people find appropriate treatment and make decisions about their future. In this video, Scripps clinical psychologist Olivia Harner, PhD, talks with San Diego Health host Susan Taylor about diagnosing and treating Alzheimer’s disease.

The most common cause of dementia, Alzheimer’s is a neurodegenerative disorder, which means it is a brain disease that progresses over time. It is associated with the buildup of two proteins, amyloid and tau, which damage nerve cells and eventually lead to cognitive decline.

Alzheimer’s-related changes can begin in the brain years before noticeable symptoms appear. The disease often begins in the temporal lobes — the brain’s memory networks — and memory loss is often the first symptom. As it progresses, it can affect many other cognitive functions, including language, problem-solving, judgment and spatial awareness.

“Our brain has all sorts of different networks,” says Dr. Harner, who specializes in neuropsychology. “Depending on which networks are affected, we can see different types of cognitive difficulties.”

Alzheimer’s disease can also cause:

• Difficulty finding words or following conversations
• Problems with planning and problem-solving
• Changes in judgment or decision-making
• Disorientation, difficulty navigating familiar places or getting lost
• Changes in mood or behavior
• Loss of interest in previously enjoyable activities

Age is the most common risk factor for Alzheimer’s disease. At age 65, about 5% of people have the disease. Most people who develop Alzheimer’s disease are diagnosed later in life; the average age of onset is about 75.

Early-onset Alzheimer’s disease refers to diagnosis before age 65. Although it is much less common, it is the same underlying disease process and can occur in people in their 40s or 50s.

Family history can also play a role. Having a parent with Alzheimer’s disease increases a person’s risk, and the risk may be higher when multiple first-degree relatives have the disease. Early-onset Alzheimer’s is usually passed down from a parent, but in most cases, not all of the children will develop the disease.

Additionally, lifestyle and other modifiable factors may account for a substantial portion of dementia risk.

If you are concerned about changes in your or a loved one’s memory or thinking, start by talking with your primary care doctor. Your doctor may perform a cognitive screening and, depending on the results, recommend additional testing.

A preliminary Alzheimer’s evaluation may include:

• Brain imaging. CT or MRI scans can provide information about the brain and help doctors look for other possible causes of cognitive changes.
• Neuropsychological testing. These detailed tests evaluate different areas of cognitive function, including memory, language, attention and problem-solving.
• Blood tests. Blood tests can help identify medical conditions that may contribute to memory or thinking problems.

Getting evaluated is an important step toward understanding what may be causing the changes.

Early evaluation can help identify potentially treatable causes of cognitive symptoms and determine whether additional testing is needed. There is currently no cure for Alzheimer’s disease, but treatments are available that may modestly slow its progression. Newer medications and additional treatments are also being studied.

An earlier diagnosis may provide a greater opportunity to benefit from available treatments. It also gives individuals and families time to understand the diagnosis and plan for the future.

“We do have medications that can modestly slow the progression of Alzheimer’s disease,” Dr. Harner says. “If we can intervene early, then hopefully we can slow the progression even more.”

Moreover, research is increasingly focused on identifying Alzheimer’s disease before significant cognitive decline occurs.

“Now is a really exciting time in Alzheimer’s disease research,” Dr. Harner says. “There’s a lot of research going on right now that’s looking to treat the disease before the damage is too late.”

Treatment for Alzheimer’s disease may include medication, lifestyle changes and management of other health conditions.

Medications can help slow the progression of the disease in some people. Your doctor can determine whether a particular treatment is appropriate based on your diagnosis, symptoms, overall health and other factors.

It is also important to manage conditions that may contribute to cognitive decline. Keeping blood pressure, diabetes and cholesterol under control can support overall brain and cardiovascular health.

There is no guaranteed way to prevent Alzheimer’s disease, but lifestyle modifications can help.

“Lifestyle plays about a 40% risk in development of the disease,” Dr. Harner says. “So, we can’t fully prevent it, but you can substantially reduce your risk.”

One of the most important steps is regular physical activity. Dr. Harner recommends aiming for about 150 minutes of exercise each week.

A healthy diet may also help. The MIND diet, which combines elements of the Mediterranean and DASH diets, emphasizes foods such as leafy green vegetables, fruits, nuts and foods rich in omega-3 fatty acids while limiting highly processed foods and added sugars.

Other habits that may support brain health include:

• Staying mentally active through reading, classes, games or learning new skills
• Maintaining meaningful social connections
• Getting adequate sleep
• Managing stress
• Treating depression and anxiety
• Limiting alcohol
• Addressing hearing and vision problems

Staying socially connected may be particularly important.

“Social isolation is a risk factor for a lot of bad medical outcomes, and it actually does increase the risk for Alzheimer's disease,” Dr. Harner says. “Even just having a few close loved ones in your life that you’re regularly interacting with in person seems to be a buffer.”