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Alzheimer’s Disease

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How is Alzheimer’s Disease Diagnosed?

Diagnosis

Alzheimer’s disease can be diagnosed using tests such as brain imaging, physical or psychological tests, and laboratory tests. Future diagnostic tests are currently being researched to determine other methods that can effectively and conclusively diagnose Alzheimer’s disease, particularly in its early stages. 

Tests to diagnose Alzheimer’s disease include: 

  • Physical evaluation. A physical assessment will be conducted to determine if other health conditions may be causing symptoms of Alzheimer’s disease. Doctors will evaluate your medical history and family history of Alzheimer’s disease, check for signs of a stroke or Parkinson’s disease, check blood pressure and pulse, and listen to the heart and lungs. Additionally, individual risk factors such as excessive alcohol consumption, head trauma, and other health conditions will be evaluated. A doctor can also test your reflexes, coordination, balance, and mobility. Diet and nutrition are also taken into consideration, along with any medications you are taking. 
  • Brain imaging. These tests can include MRI (magnetic resonance imaging), CT (computerized tomography), or PET (positron emission tomography) scans. An MRI uses radio waves and a magnetic field to produce a detailed brain image and detect abnormalities associated with cognitive impairment and Alzheimer’s disease. A CT scan uses X-rays to produce images of the brain, which may help doctors rule out other causes of dementia. This may also help doctors detect brain atrophy (the loss of neurons and the connections between them), as well as loss of brain volume. A PET scan uses a small amount of radioactive material (a radiotracer) to help doctors identify regions of the brain with abnormalities that may be associated with Alzheimer’s disease or other degenerative brain diseases.
  • Lab tests. Doctors may order blood tests for laboratory analysis to help rule out certain conditions causing symptoms associated with Alzheimer’s disease or dementia. These tests can check for vitamin deficiencies, infections, thyroid conditions, or hormonal anomalies. In certain cases, an analysis of cerebrospinal fluid may be conducted to search for certain biomarkers that can help support a diagnosis of Alzheimer’s disease.
  • Psychological tests. Neuropsychological tests can be conducted to evaluate the cognitive abilities of a patient through memory recall assessments, comprehension and reasoning exercises, and abstract thinking or problem-solving tests. This can provide doctors with useful information that can help determine a diagnosis, rule out any other factors that may be causing symptoms of dementia, and provide a baseline to help track the progression of the disease.
  • Future diagnostic tests. The development of new, advanced diagnostic tests is currently underway, and these have shown a great deal of promise when it comes to confirming a diagnosis of Alzheimer’s disease, particularly in its early stages. Tests that detect certain biomarkers (including genes or proteins such as tau) along with new imaging tests may help doctors determine a diagnosis and the progression of Alzheimer’s disease. Although more research must be conducted, experts are confident that additional tools will become available to assist efforts in detecting Alzheimer’s disease and better determining who is at risk.

How is Alzheimer’s Disease Treated?

Treatments


Treatment for Alzheimer’s disease can include medications that may ease symptoms such as memory loss and other forms of cognitive decline. There are also lifestyle remedies that may contribute to the preservation of cognitive ability.

Medications

Cholinesterase inhibitors are often prescribed to help decrease the breakdown of acetylcholine, a neurotransmitter that is diminished in the brains of individuals with Alzheimer’s disease. This can help improve symptoms by supporting the ability to remember and think more clearly and perform daily tasks, and it may also improve other psychological and behavioral symptoms such as depression and agitation. Examples of cholinesterase inhibitors used to treat Alzheimer’s disease include galantamine (Razadyne), donepezil (Aricept), and rivastigmine (Exelon). 

Memantine (Namenda) is another medication that can be prescribed to slow the progression of symptoms in individuals with Alzheimer’s disease. It functions by blocking glutamate, a neurotransmitter in the body. At normal levels, glutamate enables communication between neurons, but in people with Alzheimer’s disease, the damaged neurons produce excess glutamate that further disrupts communication between cells.

Lecanemab-irmb (Leqembi TM) is FDA-approved for slowing the progression of Alzheimer’s disease. The drug is an infusion that patients receive intravenously every two weeks. Lecanemab addresses the underlying biology of Alzheimer’s and reduces brain amyloid-beta, a key molecule in the development of Alzheimer’s disease. While the drug does not restore lost memories or cognitive function, it slows the disease’s progression when taken in the early stages of Alzheimer’s. The drug is indicated for patients clinically diagnosed with early Alzheimer’s who have  confirmation of amyloid by PET scan or spinal fluid analysis.

Lifestyle remedies

Certain lifestyle choices may contribute to the preservation of overall cognitive health. An active lifestyle with regular physical activity should be encouraged in order to promote heart, muscle, and joint health and can help an individual with Alzheimer’s disease get enough sleep. Caretakers should assist people with Alzheimer’s disease in maintaining a healthy diet and drinking plenty of fluids, as there is the possibility that they may forget to eat or drink. Diets should be rich in calories and nutrients and can be supplemented with smoothies or shakes, especially for individuals who develop difficulty eating.

Lifestyle considerations

When caring for an individual with Alzheimer’s disease, it is important to take steps toward creating a supportive and safe environment. Keeping important items such as phones, keys, wallets, and valuables in the same location can help prevent them from getting lost. It’s important to remove excess clutter and ensure that there are sturdy handrails on stairways.

Caretakers should ensure that people with Alzheimer’s disease carry identification and a mobile device with a tracking feature in case they become lost.

When possible, regular expenses such as bills should be switched to allow for automatic payments, and appointments and daily tasks should be visible on a calendar or whiteboard. Personal effects, such as family photos and items of sentimental value, should also be laid out to assist with memory. Additionally, any medications should be secured, and dosages should be closely monitored.

Encouraging continual social interactions and mental exercise can be beneficial. Frequent contact with family and loved ones, reading, crafts, and social events can support the preservation of cognitive ability. Speak with a health care provider to learn more about support programs, available resources, and additional practices that can benefit the lifestyle and care of individuals with Alzheimer’s disease.

Research

Clinical studies are currently being conducted by NewYork-Presbyterian Hospital to understand better what causes Alzheimer’s disease and discover preventative measures and possible cures. Research at Columbia University Medical Center is underway at the Gertrude H. Sergievsky Center, the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Alzheimer’s Disease Research Center to continuously advance our understanding of Alzheimer’s disease and develop new imaging, diagnostic, and treatment methods.

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FAQs

FAQs

Alzheimer’s disease is a progressive neurological disease in which brain cells die, and the brain shrinks. The death of these neurons gradually impacts an individual’s ability to remember conversations or events, reason, problem-solve, carry out simple tasks, and communicate clearly with others.

At this time, there is no cure for Alzheimer’s disease. Once symptoms appear, they will progress over time at different rates depending on the individual. Medications are available which may prevent Alzheimer's from progressing, but they will not cure the disease or reverse the damage done.

There is debate as to exactly how many stages of Alzheimer’s disease there are. However, it can generally be categorized into three main stages that track the disease’s progression: mild dementia due to Alzheimer’s disease, moderate dementia due to Alzheimer’s disease, and severe dementia due to Alzheimer’s disease. Symptoms worsen at each stage and may include increased memory loss and confusion, changes in personality and behavior, and difficulty with decision-making and planning.

Increased assistance is needed at each stage to carry out daily tasks. To learn more about the stages of Alzheimer’s disease, visit the main causes/symptoms page.

It is estimated that up to 6 million people in the United States are affected by Alzheimer’s disease, accounting for more than 60 percent of dementia cases. Most cases of Alzheimer’s disease are found in people over the age of 65, but it can also be found in younger adults.

Alzheimer’s disease will progress at a different rate depending on the individual. However, on average, people with Alzheimer’s disease will live for four to eight years, with some living as long as 20 years or more.

Typically, Alzheimer’s disease develops slowly, worsening over a period of several years after symptoms first appear. The rate of progression varies widely, and people will progress through the stages at different rates.

The first indicators of Alzheimer’s disease will appear in the form of cognitive decline. An individual’s symptoms may include having difficulty remembering recent conversations or events, and having trouble organizing their thoughts.

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Trust NewYork-Presbyterian for Alzheimer’s Disease Treatment

At NewYork-Presbyterian, our team of dedicated health care professionals understands the symptoms of Alzheimer’s disease and can provide personalized treatment and care based on your individual needs. Schedule an appointment with a health care provider to learn more about the full range of treatments and services we offer.