Alzheimer diagnostic test

How Is Alzheimer's Disease Diagnosed?

Symptoms and Diagnosis of Alzheimer’s Disease

Doctors use several methods and tools to help determine if a person with thinking or memory problems has Alzheimer’s disease. To diagnose Alzheimer’s, doctors may:

Ask the person experiencing symptoms, as well as a family member or friend, questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
Administer a psychiatric evaluation to determine if depression or another mental health condition is causing or contributing to a person's symptoms.
Conduct tests of memory, problem solving, attention, counting, and language.

Order blood, urine, and other standard medical tests that can help identify other possible causes of the problem.
Perform brain scans, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to support an Alzheimer’s diagnosis or rule out other possible causes for symptoms.

Doctors may want to repeat these tests to help best determine how the person’s memory and other cognitive functions are changing over time. The tests can also help diagnose other causes of memory problems, such as stroke, tumor, Parkinson’s disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.

People with memory problems should return to the doctor every six to 12 months.

Before the early 2000s, the only sure way to know whether a person had Alzheimer’s disease was through autopsy, a procedure that is performed after death. Thanks to advances in research, lab and imaging tests are now available to help a doctor or researcher see biological signs of the disease, or biomarkers, in a living person. For example, it is now possible for doctors to order a blood test to measure levels of beta-amyloid, a protein that accumulates abnormally in the brains of people with Alzheimer’s. Several other blood tests are in development. However, the availability of these diagnostic tests is still limited. NIA-supported research teams continue to study options for faster, less-expensive, and less-invasive ways to diagnose Alzheimer’s.

Learn more about biomarkers and Alzheimer’s detection and research.

What happens if a doctor thinks it's Alzheimer's disease?

If a primary care doctor suspects Alzheimer’s, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:

Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.
Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
Neuropsychologists, who can conduct tests of memory and thinking.

Memory clinics and centers, including Alzheimer’s Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.

What are the benefits of an early Alzheimer's diagnosis?

Alzheimer’s disease slowly worsens over time. People living with this disease progress at different rates, from mild Alzheimer’s, when they first notice symptoms, to severe, when they are completely dependent on others for care.

Early, accurate diagnosis is beneficial for several reasons. While there is no cure, there are several medicines available to treat Alzheimer’s, along with coping strategies to manage behavioral symptoms. Beginning treatment early in the disease process may help preserve daily functioning for some time. Most medicines work best for people in the early or middle stages of the disease. Learn more about Alzheimer’s medications.

In addition, having an early diagnosis helps people with Alzheimer’s and their families:

Plan for the future
Take care of financial and legal matters
Address potential safety issues
Learn about living arrangements
Develop support networks

An early diagnosis also provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimer’s.

For more information about Alzheimer's

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
[email protected]
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov portal for information and resources on Alzheimer’s and related dementias from across the federal government.

Eldercare Locator
800-677-1116
[email protected]
https://eldercare.acl.gov

MedlinePlus
National Library of Medicine
www.medlineplus.gov

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: September 09, 2021

Medical Tests for Diagnosing Alzheimer's & Dementia

There is no single diagnostic test that can determine if a person has Alzheimer’s disease. Physicians (often with the help of specialists such as neurologists, neuropsychologists, geriatricians and geriatric psychiatrists) use a variety of approaches and tools to help make a diagnosis. Although physicians can almost always determine if a person has dementia, it may be difficult to identify the exact cause.

Medical history
Brain imaging
Physical exam and diagnostic tests
Cerebrospinal fluid (CSF) tests
Neurological exam
Blood tests
Mental cognitive status tests

Medical history

During the medical workup, the health care provider will review the person's medical history, including psychiatric history and history of cognitive and behavioral changes. He or she will want to know about any current and past medical problems and concerns, as well as any medications the person is taking. The doctor will also ask about key medical conditions affecting other family members, including whether they may have had Alzheimer's disease or other dementias.

Physical exam and diagnostic tests

During a medical workup, the physician will likely:

What to expect

Take our interactive tour to learn what to expect when being evaluated for memory and thinking problems.

Take the Tour

Ask about diet, nutrition and use of alcohol.
Review all medications. (Bring a list or the containers of all medicines currently being taken, including over-the-counter drugs and supplements.)
Check blood pressure, temperature and pulse.
Listen to the heart and lungs.
Perform other procedures to assess overall health.
Collect blood or urine samples for laboratory testing.

Information from a physical exam and laboratory tests can help identify health issues that can cause symptoms of dementia. Common causes of dementia-like symptoms are depression, untreated sleep apnea, delirium, side effects of medications, thyroid problems, certain vitamin deficiencies and excessive alcohol consumption. Unlike Alzheimer’s and other dementias, these conditions often may be reversed with treatment.

If the diagnosis is Alzheimer’s or another dementia, you or your loved one are not alone. Join our free online community ALZConnected to share questions, experiences and practical tips on message boards and in live chat rooms.

Be prepared for the doctor to ask:

What kind of symptoms have you noticed?
When did they begin?
How often do they happen?
Have they gotten worse?

The doctor may also ask a family member to provide input about changes in your thinking skills and behavior. See our Communicating with Doctors or Health Care Professionals (PDF) to get ready for your appointment.

Neurological exam

During a neurological exam, the physician will closely evaluate the person for problems that may signal brain disorders other than Alzheimer's. The doctor will look for signs of stroke, Parkinson's disease, brain tumors, buildup of fluid in the brain, and other conditions that may impair memory or thinking.

The physician will test:

Reflexes.
Coordination, muscle tone and strength.
Eye movement.
Speech.
Sensation.

The neurological exam may also include a brain imaging study.

If the evaluation does not indicate Alzheimer's disease or another dementia, but the symptoms continue to get worse over time, your doctor may need to order more tests, or you may wish to get a second opinion.

Learn more: What Is Alzheimer's?, What Is Dementia? and Types of Dementia.

Home screening tests for dementia

A number of dementia screening tests have been marketed directly to consumers. None of these tests have been scientifically proven to be accurate. Furthermore, the tests can have false-positive results, meaning that individuals can have results saying they have dementia when in fact they do not. This is extremely unlikely to happen if the individual visits a physician to seek care and potential diagnosis. For these and other reasons, the Alzheimer's Association believes that home screening tests cannot and should not be used as a substitute for a thorough examination by a skilled doctor. The whole process of assessment and diagnosis should be carried out within the context of an ongoing relationship with a responsible and qualified health care professional.

Mental cognitive status tests

Mental cognitive status testing evaluates memory, thinking and simple problem-solving abilities. Some tests are brief, while others can be more time intensive and complex. More comprehensive mental cognitive status tests are often given by a neuropsychologist to evaluate executive function, judgment, attention and language.

Such tests give an overall sense of whether a person:

Is aware of symptoms.
Knows the date, time, and where he or she is.
Can remember a short list of words, follow instructions and do simple calculations.

Mini-Mental State Exam (MMSE) and the Mini-Cog test

The MMSE and Mini-Cog test are two commonly used assessments.

During the MMSE, a health professional asks a patient a series of questions designed to test a range of everyday mental skills. The maximum MMSE score is 30 points. A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer's declines about two to four points each year.

During the Mini-Cog, a person is asked to complete two tasks:

Remember and a few minutes later repeat the names of three common objects.
Draw a face of a clock showing all 12 numbers in the right places and a time specified by the examiner.

The results of this brief test can help a physician determine if further evaluation is needed.

Computerized tests cleared by the FDA

A growing area of research is the development of devices to administer computer-based tests of thinking, learning and memory, called cognitive tests.

The U.S. Food and Drug Administration (FDA) has cleared several computerized cognitive testing devices for marketing. These are the Cantab Mobile, CognICA, Cognigram, Cognivue, Cognision and Automated Neuropsychological Assessment Metrics (ANAM) devices.

Some physicians use computer-based tests such as these in addition to the MMSE and Mini-Cog. Computerized tests have several advantages, including giving tests exactly the same way each time. Using both clinical tests and computer-based tests can give physicians a clearer understanding of cognitive difficulties experienced by patients.

Depression screen and mood assessment

In addition to assessing mental status, the doctor will evaluate a person's sense of well-being to detect depression or other mood disorders that can cause memory problems, loss of interest in life, and other symptoms that can overlap with dementia.

Genetic testing

Researchers have identified certain genes that increase the risk of developing Alzheimer's and other rare "deterministic" genes that directly cause Alzheimer's. Although genetic tests are available for some of these genes, health professionals do not currently recommend routine genetic testing for Alzheimer's disease.

Risk genes: While there is a blood test for APOE-e4, the strongest risk gene for Alzheimer's, this test is mainly used in clinical trials to identify people at higher risk of developing Alzheimer's. Carrying this gene mutation only indicates a greater risk; it does not indicate whether a person will develop Alzheimer's or whether a person has Alzheimer's. Genetic testing for APOE-e4 is controversial and should only be undertaken after discussion with a physician or genetic counselor.

Deterministic genes: Testing also is available for genes that cause autosomal dominant Alzheimer's disease (ADAD) or "familial Alzheimer's," a rare form of Alzheimer's that accounts for 1 percent or less of all cases. ADAD runs strongly in families and tends to begin earlier in life, sometimes as early as one’s 30s. Many people in these families do not wish to know their genetic status, but some get tested to learn whether they will eventually develop the disease. Some ADAD families have joined clinical studies to help researchers better understand Alzheimer's.

Learn more: Genetic Testing Fact Sheet (PDF) and Genetics and Alzheimer's.

Brain imaging

A standard medical workup for Alzheimer's disease often includes structural imaging with magnetic resonance imaging (MRI) or computed tomography (CT). These tests are primarily used to rule out other conditions that may cause symptoms similar to Alzheimer's but require different treatment. Structural imaging can reveal tumors, evidence of small or large strokes, damage from severe head trauma, or a buildup of fluid in the brain.

In some circumstances, a doctor may use brain imaging tools to find out if the individual has high levels of beta-amyloid, a hallmark of Alzheimer’s; normal levels would suggest Alzheimer’s is not the cause of dementia.

Imaging technologies have revolutionized our understanding of the structure and function of the living brain. Researchers are studying other brain imaging techniques so they can better diagnose and track the progress of Alzheimer’s.

Cerebrospinal fluid (CSF) tests

CSF is a clear fluid that bathes and cushions the brain and spinal cord. Adults have about 1 pint of CSF, which physicians can sample through a minimally invasive procedure called a lumbar puncture, or spinal tap. Research suggests that Alzheimer's disease in early stages may cause changes in CSF levels of multiple markers such as tau and beta-amyloid, two markers that form abnormal brain deposits strongly linked to Alzheimer's. Another potential marker is neurofilament light (NfL), an increased level of which has been found in neurodegenerative diseases such as Alzheimer’s.

One challenge researchers face is that analysis of biomarker levels in the same sample can often vary significantly from institution to institution and across different testing platforms. Great strides have been made in standardizing the measurement of these markers in research and clinical care. CSF tests are currently used by dementia specialists to aid in the diagnosis of Alzheimer's, and research continues to develop and standardize new markers that will aid in diagnosis and detection of other dementias.

One CSF Amyloid Ratio test, Lumipulse®, received FDA approval and is a new diagnostic tool that clinicians can use to detect amyloid in CSF, which can be predictive of amyloid changes in the brain.

The Alzheimer's Association convened a multidisciplinary workgroup and published appropriate use criteria to guide the safe and optimal use of the lumbar puncture procedure and CSF testing for Alzheimer's disease.

Blood tests

Researchers are investigating whether consistent and measurable changes in blood levels of specific markers may be reliably associated with Alzheimer’s related changes. These markers may include tau, beta-amyloid or other biomarkers the could be measured before and after symptoms appear.

An urgent need exists for simple, inexpensive, non-invasive and easily available diagnostic tools such as blood tests to diagnose the disease. These testing technologies would support drug development by helping to identify and follow treatment effectiveness in clinical trial participants and to increase the possibility of early detection, diagnosis and intervention. A blood test would also enable interpretation and understanding of the progression of Alzheimer’s in larger and more diverse populations.

Today, blood tests are already improving the design of clinical trials, and they are being used in some specialty care centers. In the future, they are very likely to revolutionize the diagnostic process for Alzhiemer’s and all other dementia. The use of these tests in trials and at the doctor's office must be done in a careful and controlled way because much more research is still needed before they can be routinely used in the clinic, as researchers are still working toward creating standardized and validated tests that will deliver reliable results for all individuals.

There are a few blood tests currently on the market that can be ordered by health care providers to aid in the diagnosis of memory complaints. These tests do not yet have FDA approval. At this time, it is recommended that blood tests only be used by specialty care doctors who are seeing patients with memory complaints. They are not recommended for individuals who do not have any cognitive or memory symptoms.

The currently available tests may predict the presence of amyloid changes in the brain or the presence of neurodegenerative disease or neuronal damage. These blood tests cannot be used as a stand-alone test to diagnose Alzheimer’s disease or any other dementia; they will be used as part of a diagnostic workup with other exams.

Tests for Alzheimer's disease in the elderly + questionnaire for relatives

Alzheimer's disease (AD) is an irreversible form of memory loss, the death of brain cells. Most often it is inherent in the elderly (over 65 years old) age. World statistics show that an increasing number of older people are facing this disease. Moreover, it not only progresses, but also “gets younger”. Unfortunately, not a single scientist has yet been able to find an effective treatment against AD. But as practice shows, the sooner it is detected, the more effective the effect of therapy aimed at stopping regressive processes in the brain. That is why it is so important to closely monitor the condition of your loved ones the elderly and consult a doctor in a timely manner.

Key symptoms: what to look out for

A particular danger of Alzheimer's disease is in its implicit symptoms in the initial illness. Well, what if the grandmother forgot where she put her glasses or hardly remembers the name of her newborn grandson. As a rule, this is attributed to old age and few people pay attention to such bells. But they can be the first signs of an impending disease.

In order to recognize AD in time, first of all, follow the perception of time by the elderly. If he sets to cook food and completely forgot about it or went to brush his teeth and spent more than an hour in the bathroom, then you should consult a doctor. Other common signs of illness for pensioners are:

sudden problems in performing everyday activities for them that require attention and memory: inability to finish the pattern started in knitting, drive a car, do homework, etc . ;
loss in space. A person is suddenly lost in a familiar place, cannot figure out where to go;
communication problems. The patient does not fully express his thought, although earlier it was not difficult. It is also important to monitor the inability to create logical chains, to complete the phrase.

Often the development of pathology causes personality changes, mood swings. They manifest themselves in apathy, irritability. Moreover, in most cases, men experience outbursts of anger, and women - vulnerability, secrecy and irritability.

First step for diagnosis: Alzheimer's predisposition test

Many people are unaware that they have a predisposition to Alzheimer's disease. Experts agree that considering yourself absolutely healthy is a serious delusion. Periodically, you can take a simple test in order to determine if you are likely to get this disease in the future.

For the test, you need to answer three questions:

Do you have moments when it is difficult to remember where you put the keys (if they are not in the usual place)?
Do you ever find yourself unable to recognize your reflection in the mirror?
Do you ever forget what you were doing a minute ago?

If at least one question is answered yes, it means that Alzheimer's disease is not excluded in the future. For prevention, you need to spend more time outdoors, engage in intellectual activities (reading books, solving crossword puzzles, board games). Moderate physical activity and brain training are required. You can learn poems by heart, pronounce tongue twisters, etc.

If someone close to you is suspicious of strange, inexplicable behavior, special tests can also be carried out on him. Tasks in this case will be more substantive and specific, they were developed by psychologists and psychotherapists.

Questionnaire

In view of the urgency of the problem and in the desire to help relatives determine the presence of early stages of Alzheimer's disease in an elderly person, special questionnaires have been developed in many research centers. They allow you to draw certain conclusions and, if necessary, seek the advice of a doctor in a timely manner. We offer one of them, developed with the support of the Banner Sun Health Research Institute (Arizona, USA). It allows you to consider the problem comprehensively, to identify different aspects of the disease.

Give affirmative or negative answers. For each positive, a certain point is awarded. If negative, "0" is set.

Question	Number of points for "Yes"
A relative has a bad memory	one
The problem with memory has worsened lately	one
He forgets about planned things	one
Often asks the same questions throughout the day, shares the same story several times	2
Items are lost or cannot be found more than once a month	one
In case of difficulty in finding the right things, suspicions are expressed that they were hidden, shifted or stolen	one
Often there is an inability to remember the current date (year, month, day), determine the time of day	2
Lost in unfamiliar places	one
Experiencing discomfort while traveling, away from home	one
A relative has problems with handling cash: when paying in a store, transport, etc.	one
Difficulties in filling out receipts, paying bills	2
Does he forget to take necessary medications?	one
Difficulty driving a car	one
Does it cause difficulty turning on the microwave or stove, setting the time on the alarm clock	one
Difficulty performing daily chores around the house (if the reason is not in physical form)	one
Decreased interest in hobbies	one
A person is lost in familiar places	2
It happened that he started moving in the wrong direction	one
It happened that he could not find the right words when talking	one
Confuses or forgets the names of close acquaintances, family members	2
It happened that he did not recognize a friend	2

After answering all the questions, the scores should be summed up. Depending on the result obtained, the following options are possible:

up to 5 - the mental health of your relative is not a concern;
5-14 - signs of moderate cognitive impairment are observed, which often lead to the development of AD. That is why it is recommended to consult a doctor;
more than 14 - the patient needs medical care, and a specialist should be contacted as soon as possible.

It is easy to find other developments, but when answering questions and counting the results, it is important to remember that they all have a recommendatory form. It is impossible to make a diagnosis only on the basis of a questionnaire. There are also a large number of tests that allow you to establish a person's tendency to progression of the pathology or determine its symptoms. But they do not give a complete picture. Only an experienced specialist on the basis of analyzes and specific studies can identify asthma.

Testing abstract thinking skills

One of the important symptoms of the development of Alzheimer's disease is the difficulty in perceiving abstract concepts. This is what this test focuses on. It is carried out in two stages. At the beginning, an elderly person is asked to name 10 types of animals in a minute. And immediately after that, remember the same number of names starting with a certain letter. You should not choose a difficult option, let it be "A" or "L".

At the second stage, the elderly person is invited to read an abstract text. It must be printed. For example, you can take the option:

94NN03 S006SCH3NN3 P0K4ZY8437, K4KN3 U9N8N73LNY3 83SCHN M0ZH37
93L47L N4Sh R4ZOOM!
8P3CH47LAYUSCHN3 83SCHN!
SN4CH4L4 E70 6YL0 7RU9N0, N0 S3YCH4S N4 E70Y S7R0K3 84SH R4ZUM
CHN7437 E70 4870M47NCH3SKN, H3 Z49MY84YAS 06 E70M. G0P9NC.
LNSH 0PR393L3NNY3 LU9N M0GU7 PR0CHN747E70.

The patient's brain loses the ability to think abstractly, it is not able to quickly analyze information and provide the necessary information. That is why, with a developing disease, it will be difficult to complete these tasks. Of course, healthy people can make some mistakes.

Picture test

Researchers at the University of Louisville found that the medial temporal lobes needed to be involved in a number of simple tasks. However, they are among the first to be affected in Alzheimer's disease. This became the basis for the development of this diagnostic technique. The test is completely simple. The subject is presented with several series of pictures. Each includes 4 images: 3 of the same object (for example, a hat or a cake) from different angles or different colors, and the fourth one is different. The essence of the task is to search for the superfluous. Failure to solve a simple problem may indicate a predisposition to the disease.

Smell test

Along with the parts of the brain responsible for short-term memory, the olfactory nerves also degrade. To establish these signs of the development of the disease, you will need a jar of peanut butter (it has a recognizable specific aroma) and a long (25 cm or more) ruler. An elderly relative should be asked to cover his right nostril with his finger. At this time, bring oil to the left at a distance of 23 cm. When inhaling, a person should clearly distinguish the aroma of peanuts.

Hidden character task

To complete it, you will need a sheet filled with the same type of images with rare exceptions. For example, rows of nines, among which there are several sixes, or the letters "O" with "C". The main thing is that the font is not too small and is easy to read. You should evaluate the speed of reaction, whether the subject was able to complete the test and how long it took.

Terminals

To identify the first signs of Alzheimer's disease, other methods have been developed that are easy to use at home. But all of them are exploratory in nature and allow you to establish whether you need to worry about your loved one. If you have any doubts, it is better to contact a specialist who will give a professional opinion. Health to you and your loved ones.

Alzheimer's test. How not to get sick?

Alzheimer's disease is called the epidemic of the XXI century: it is predicted that by 2050 the number of patients with this syndrome will triple. And the main problem is that the disease is almost untreatable and all that can be done is to slow down its development to one degree or another. Here, scientists note that therapy would be much more effective if addressed at the earliest stages. However, to date, there are no developed methods that can determine the onset of cognitive impairment before the onset of symptoms.

The latest research was an important step in this direction. Scientists from Georgetown University (USA) have developed a blood test that, in their opinion, is able to diagnose Alzheimer's disease and other forms of dementia at an early stage, long before the first symptoms begin to appear.

In our material you will learn the essence of the test for Alzheimer's disease. For those who want to check themselves and loved ones, the company " Treatment Abroad " offers an examination option that will identify early signs of the disease.

Alzheimer's Test

Decades have been sought for a diagnostic test for Alzheimer's that is accurate and easy to use, yet cost-effective, non-invasive, and capable of reliably detecting disease at its earliest stages . Therefore, the blood test method invented by American researchers has become a real discovery that meets almost all requirements.

Scientists from Georgetown University decided to look for signs of the development of the syndrome even before the disease manifested itself (the disease has a latent period of development lasting more than 10 years, when the symptoms of the disease are not expressed in any way). The researchers studied during the experiment 525 older people over 70 years old. For five years they were closely monitored, and as a result, 53 subjects were diagnosed with mild symptoms of Alzheimer's disease , despite the fact that 18 of them did not have such symptoms at the beginning of the study.

American scientists used a blood test for diagnosis. They found differences in the content of 10 different lipids (or fats and fat-like substances that enter the blood after the destruction of the membrane of nerve cells). They allow predicting the development of the disease with a certainty of up to 90% in the next three years and indicate to those who have passed this test the risk of developing senile dementia in the near future.

Cell membranes of two nearby neurons

Their findings, published in Nature Medicine, experts say need confirmation and will be tested in large clinical trials, but the test is "a real step forward."

Professor of neurology at Georgetown University Howard Federoff believes such a test is necessary, it can help in the detection of Alzheimer's disease and change attitudes towards treatment, because clinical trials of drugs will be carried out at an early stage and therefore have greater effectiveness.

Treatment of Alzheimer's disease abroad

The company " Treatment Abroad " found out that at the moment the described method is not used in any foreign clinic.

Learn more