• Receiving a diagnosis of Alzheimer’s Disease (AD) is usually upsetting for the patient, family and friends. With knowledge lacking, devastation, fear, and uncertainty of what to do, become first thoughts. Reality is that a diagnosis of AD is currently a hypothesis to be proven over time. The following offers a guide for realism.
  1. AD has definite markers and is a slow progresses disease (my wife is in her 19th year).
  2. An AD diagnosis should confirm that the patient has amyloid plaques and Tau fibrils and tangles which begin in the transentorhinal and entorhinal cortex along with atrophy of the hippocampus.  Confirmation tests are not nornal as they require Cerebral Spinal Fluid analysis, along with MRI’s, and PET Scans (all expensive and not covered by insurance).  Other than clinical trials or until a cost-effective biological markers (such as blood tests) are approved, subjective cognitive symptoms are used to judge if a person has AD.
  3. Until recently, the Mini Mental State Exam (MMSE) was commonly used by primary care doctors and neurologist. It is a fairly accurate gauge of progressive decline.  Unfortunately, it has been put under copyright whereby it uses has declined.  MMSE score range is 30 to 0.  A score of 30 to 25 would indicate Mild Cognitive Impairment (MCI) and 6 to 0 indicating dementia.  In addition, MRIs are useful in identified damage and atrophy within the brain.
  4. Uncertainty enters the diagnosis when symptoms associated with other mental disorders are present with some memory problems. The diagnosis is often made erroneous as AD.   Symptoms other than memory at the initial disease stage (MCI) indicate a mental disorder other than AD.
  5. Realism is, if the diagnosis is accurate and correct and at the MMSE score of 30 or 29,  the patient probably has between 7 and 10 years of a fairly normal lifestyle.  Demanding issues for caregivers begin with behavior, agitation, anxiety, wandering and unable to independently sustain Activities of Daily Living (ADL) that provides an alert for Dementia.
  6. I have shared my Caregiver experience along with my self-educated knowledge of evidenced based research in my book, as well as my web site blogs at https://alzheimersabcs.com (The book contains signs and symptoms linked to MMSE scores as the disease progresses).
  7. My wife has now been in memory care for the past 4 years, I have observed symptoms for various mental disorders and believe behavior issues reflect a patient’s upbringing and the value system they developed, whether good or problematic
  8. Some observation pointers are a) Frontotemporal Disease usually begins with problems finding words to complete a sentence;   b) Lewy Body Disease symptoms include  hallucinations and paranoia;  Parkinson Disease symptoms include tremors, gait and balance problems; d0 Vascular include functional issues (maybe  incontinence) without memory problems.

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