Consulting the Doctor
Identifying mild cases of Alzheimer's disease can be very
difficult. Your doctor will review your
health and mental status, both past and present. Changes from
your previous, usual mental and
physical functioning are especially important.
Persons with Alzheimer's disease may not realize the severity of
their condition. Your doctor
will probably want to talk with family members or a close friend
about their impressions of your
condition.
The doctors first assessment for Alzheimer's disease should
include a focused history, a
physical examination, a functional status assessment, and a
mental status assessment.
Medical and Family History
Questions the doctor may ask in taking your history include: How
and when did problems begin?
Have the symptoms progressed in steps or worsened steadily? Do
they vary from day to day?
How long have they lasted?
Your doctor will ask about past and current medical problems and
whether other family
members have had Alzheimer's disease or another form of
dementia.
Education and other cultural factors can make a difference in how
you will do on mental ability
tests. Language problems (for example, difficulty speaking
English) can cause misunderstanding.
Be sure to tell the doctor about any language problems that could
affect your test results.
It is important to tell the doctor about all the drugs you take
and how long you have been taking
them. Drug reactions can cause dementia. Bring all medication
bottles and pills to the
appointment with your doctor.
Do you take any medications? Even over-the-counter drugs,
eye drops, and alcohol can cause
a decline in mental ability. Tell your doctor about all the drugs
you take. Ask if the drugs are
safe when taken together.
Physical Examination
A physical examination can determine whether medical problems may
be causing symptoms of
dementia. This is important because prompt treatment may relieve
some symptoms.
Functional Status Assessment
The doctor may ask you questions about your ability to live
alone. Sometimes, a family member
or close friend may be asked how well you can do activities like
these:
- Write checks, pay bills, or balance a checkbook.
- Shop alone for clothing, food, and household needs.
- Play a game of skill or work on a hobby.
- Heat water, make coffee, and turn off stove.
- Pay attention to, understand, and discuss a TV show, book,
or magazine.
- Remember appointments, family occasions, holidays, and
medications.
- Travel out of the neighborhood, drive, or use public
transportation.
Sometimes a family member or friend is not available to answer
such questions. Then, the doctor
may ask you to perform a series of tasks ("performance
testing").
Mental Status Assessment
Several other tests may be used to assess your mental status.
These tests usually have only a few
simple questions. They test mental functioning, including
orientation, attention, memory, and
language skills. Age, educational level, and cultural influences
may affect how you perform on
mental status tests. Your doctor will consider these factors in
interpreting test results.