AEIF Newsletter 6: How to Establish a Diagnosis of Alzheimer’s Disease

January 15th, 2022


A standardized protocol for early detection of Alzheimer's Disease must be adopted at a national level to formulate a standardized database for the management, research, analysis and prognostication of AD. The design of this infrastructure will be crucial for accurate comparative analysis and our foundation is presently involved in these developments.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

Among the earliest symptoms of Alzheimer’s Disease are:

Memory impairment

Diminished concentration

Disorientation

Difficulties completing normal daily tasks

Curtailed vocabulary

Social withdrawal

Poor judgment

Aberrant behavior

Mood swing

Distrust and paranoia

Irrational and poorly modulated anger

Recurring transient bouts of confusion.



Differential diagnosis is extremely important during this process. Past medical history, social history and family history are also examined. 


Differential Diagnosis of Dementia by Category:

  1. Vascular

Multi-infarct Dementia

Subarachnoid hemorrhage 

2. Metabolic

Wernicke-Korsakoff (Alcoholic) 

Kidney Dialysis

Hypothyroidism

Vitamin Deficiencies 

3. Traumatic Encephalopathy 

Chronic Traumatic Encephalopathy (CTE)

Head Injury

Repeated Loss of Consciousness

4. Genetic/Hereditary

Lewy Body

5. Mechanical

Normal Pressure Hydrocephalus

6. Neurodegenerative

Alzheimer’s Disease

Huntington’s Disease

Parkinson’s Disease

7. Post-Radiation

8. Post-Chemotherapy

9. Infectious

Post-Infectious Syphilis

Meningitis

10. Tumors

Benign

Malignant

Diagnostic and Evaluation of Suspected Dementia Cases

A. Laboratory Data

B. Radiographic Testing

1. CT Scan

2. MRI with or without Contrast

3. Functional MRI

4. FDG Pet CT Scan

5. Beta-Amyloid PET CT and Tau

C. Electrophysiological Studies

1. Olfactory Evoked Potentials

2. The P300 Wave

3. Central Auditory Processing (CAP) Test

According to the Framingham Heart Study, Central Auditory Processing disorders may be present as an early manifestation of Alzheimer’s Disease, preceding AD by a minimum of five years and a maximum of as many as 10 years.

4. Brainstem Auditory Evoked Response Test (BAER)

D. Smell impairment tests (SIT)

E. Optical Testing


Evaluation of Cognitive Function

 A referral will also be issued to our expert Alzheimer’s Disease neurologists for baseline and follow-up MCI testing. To obtain our automated, reliable MCI test for yourself, a friend or family member, please contact us at annearlyintervention.org/contact.



Works Cited:

  1. Differential Diagnosis of Neurodegenerative Dementias Using Metabolic Phenotypes on F-18 FDG PET/CT Madhavi Tripathi, Manjari Tripathi, Nishikant Damle, Suman Kushwaha, Abhinav Jaimini, Maria                   M. D’Souza, Rajnish Sharma, Sanjiv Saw, Anupam Mondal Neuroradiol J. 2014 Feb; 27(1): 13–21. Published online 2014 Feb 24. doi: 10.15274/NRJ-2014-10002

  2. Brain PET in the Diagnosis of Alzheimer’s Disease Charles Marcus, Esther Mena, Rathan M. Subramaniam Clin Nucl Med. Author manuscript; available in PMC 2015 Feb 18. Published in final edited form as: Clin Nucl Med. 2014 Oct; 39(10): e413–e426. doi: 10.1097/RLU.0000000000000547

  3. “Biomarkers for Dementia Detection and Research”. National Institute on Aging. 2021. 

  4. “The Clinical Use of Structural MRI in Alzheimer’s Disease”. Giovanni B. Frisoni, Nick C. Fox, Clifford R. Jack, Jr, Philip Scheltens and Paul M. Thompson”. February 1st, 2011. 

  5. “Electrophysiological Assessment Methodology of Sensory Processing Dysfunction in Schizophrenia and Dementia of the Alzheimer’s Type”. Viardot G. Danjou, Maurice D. Feb. 2019.