Using Diagnostic Imaging
There is no one Alzheimer Test that can conclusively diagnose Alzheimer’s. However, there are several tests that can be used to help in diagnosing Alzheimer’s.
Unfortunately, as a neurodegenerative disease, it does not lead itself to simplicity. Diagnosis is based on a review of clinical symptoms, progression over time and eliminating other reasons for the symptoms.
Differential diagnosis should include brain tumors, metabolic disorders, strokes, aneurysms and frontal temporal dementia, just to name a few. Most of these can be ruled out using these imagining tests.
A brief overview will help you understand the most common diagnostic Alzheimer test. Knowing what you can do to help and support your loved one through this testing can make the procedures easier for you both.
CT Scan: Usually The First Alzheimer Test
A CT scan, commonly called a CAT Scan, can be done either with or without contrast. If your loved one is allergic to iodine, or shellfish, please make sure to let your physician know prior to the test to avoid what can be a life threatening reaction.
CT stands for computed tomography, giving a two dimensional view of the brain. It takes picture “slices” of the brain to evaluate the structural status of the brain. There are some CT Scans that are capable of producing three dimensional views of the brain as well.
The test will require that your elderly loved one lays flat on their back for an extended period of time. The stretcher type surface that they lay on will then enter into the machine while the pictures are taking place.
Another Alzheimer Test: The MRI
MRI, magnetic resonance imaging, is a test that uses magnetic fields and radio waves. It provides a much more detailed look at the structure of the brain.
In Alzheimer’s, the MRI may be able to show focal areas of atrophy, showing decreased areas of brain tissue that have been affected by the disease process. It can also be used to rule out other diseases.
An MRI is loud, producing a loud “hammer” like noise while the patient is inside of it and the test takes approximately 20 minutes to complete. Some people become quite claustrophobic. Make sure to let your physician know if you or your loved one thinks this may be an issue.
The PET Scan
A PET Scan stands for positron emission tomography. It is capable of providing both a two and a three dimensional view of the brain activity by measuring radioactive isotopes that are injected into the blood stream.
Your loved one will have an IV placed, usually in the arm, and the radioactive isotopes will be injected. That process usually takes about 45 minutes. The scan itself can range anywhere from 30 minutes to an hour and your elderly family member will need to hold still during the entire exam.
PET Scans are still primarily being used in Alzheimer’s research. At this time, medicare may not pay for a PET for diagnostic purposes only, unless the scan is being used to differentiate between frontal temporal dementia and Alzheimer’s Dementia.
Make sure to check with your insurance company and Medicare prior to getting the test to make sure they will cover it.
What You Can Do To Help
1. Most likely, you will not be allowed inside the testing room next to your loved one. However, there are some imaging centers that may allow you in to support your loved one through the process. Check with the center ahead of time.
2. Make sure to tell the imaging center about any and all allergies.
3. The imaging center should contact you prior to the test to get a full medical history. Make sure you let them know all medications your loved one is on, including over the counter medications and supplements.
4. If laying flat will be an issue with pain, breathing or anxiety, talk to the doctor and the imaging center ahead of time. It is often necessary, and recommended, to pre medicated the patient prior to the beginning of the test.
5. Prior to leaving the testing center, ask for a written report of the results of the scan. If they are not immediately available, you can sign a release at that time to have the results mailed to you. Remember that you are going to need your loved ones signature unless you bring your Power of Attorney paperwork.
6. It is wise to have a copy of all test results in your home care file. You may not understand everything written on the report, but other physicians will. If you have copies, it will make life easier for you and your family member and any appointment with a specialist for follow up will be smoother.
7. If your loved one will be pre-medicated, they will not be allowed to drive home from the imaging center. They will probably be a little disoriented and drowsy for several hours to several days.
8. An appointment late in the day may be most beneficial for you both.
9. Make sure they are not left alone following the test. Although may look okay to you, the effects of the medication may not have worn off and can lead to serious safety concerns.
The entire workup for diagnosing Alzheimer's can be overwhelming and stressful.
Knowing in advance what is going to happen can help make this process easier.
Unfortunately, there is no one Alzheimer Test that can conclusively diagnose the disease. Most likely, your loved one will go through a series of testing to rule out any other cause of the symptoms.
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