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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.
Alzheimer's disease affects two major types of abilities:
1. The ability to carry out everyday activities such as bathing, dressing, using the toilet, eating, and walking.
2. The ability to perform more complex tasks such as using the telephone, managing finances, driving a car, planning meals, and working in a job.
When a person has Alzheimer's disease, problems with complex tasks appear first and over time progress to more simple activities.
Treatable Causes of Dementia
Sometimes the physical examination reveals a condition that can be treated. Symptoms may respond to early treatment when they are caused by:
Medication (including over-the-counter drugs).
Problems with the heart, lungs, or blood vessels.
Metabolic disorders (such as thyroid problems).
Vision or hearing problems.
Drug reactions are the most common cause of treatable symptoms. Older persons may have reactions when they take certain medications. Some medications should not be taken together. Sometimes, adjusting the dose can improve symptoms.
Delirium and depression may be mistaken for or occur with Alzheimer's disease. These conditions require prompt treatment.
Gathering as much information as possible will help your doctor diagnose early Alzheimer's disease while the condition is mild. You may be referred to other specialists for further testing. Some special tests can show a persons mental strengths and weaknesses and detect differences between mild, moderate, and severe impairment. Tests also can tell the difference between changes due to normal aging and those caused by Alzheimer's disease.
If you go to a special doctor for these tests, he or she should return all test results to your regular family doctor. The results will help your doctor track the progress of your condition, prescribe treatment, and monitor treatment effects.
Getting the Right Care
When the diagnosis is Alzheimer's disease, you and your family members have serious issues to consider. Talk with your doctor about what to expect in the near future and later on, as your condition progresses. Getting help early will help ensure that you get the care that is best for you.
When tests do not indicate Alzheimer's disease, but your symptoms continue or worsen, check back with your doctor. More tests may be needed. If you still have concerns, even though your doctor says you do not have Alzheimer's disease, you may want to get a second opinion.
Whatever the diagnosis, followup is important.
Report any changes in your symptoms. Ask the doctor what followup is right for you. Your doctor should keep the results of the first round of tests for later use. After treatment of other health problems, new tests may show a change in your condition.
Recognizing Alzheimer's disease in its early stages, when treatment may relieve mild symptoms, gives you time to adjust. During this time, you and your family can make financial, legal, and medical plans for the future.
Your health care team may include your family doctor and medical specialists such as psychiatrists or neurologists, psychologists, therapists, nurses, social workers, and counselors. They can work together to help you understand your condition, suggest memory aids, and tell you and your family about ways you can stay independent as long as possible.
Talk with your doctors about activities that could be dangerous for you or others, such as driving or cooking. Explore different ways to do things.
Telling Family and Friends
Ask your doctor for help in telling people who need to know that you have Alzheimer's disease members of your family, friends, and coworkers, for example.
Alzheimer's disease is stressful for you and your family. You and your caregiver will need support from others. Working together eases the stress on everyone.
Where To Get Help?
Learning that you have Alzheimer's disease can be very hard to deal with. It is important to share your feelings with family and friends.
Many kinds of help are available for persons with Alzheimer's disease, their families, and caregivers. These resources include:
Support groups. Sometimes it helps to talk things over with other people and families who are coping with Alzheimer's disease. Families and friends of people with Alzheimer's disease have formed support groups. Many hospitals also sponsor education programs and support groups to help patients and families.
Financial and medical planning. Time to plan can be a major benefit of identifying Alzheimer's disease early. You and your family will need to decide where you will live and who will provide help and care when you need them.
Legal matters. It is also important to think about certain legal matters. An attorney can give you legal advice and help you and your family make plans for the future. A special document called an advance directive lets others know what you would like them to do if you become unable to think clearly or speak for yourself.
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