DIAGNOSTICS OF ALZHEIMER'S DISEASE

Diagnosis of Alzheimer's disease

To Alzheimer's diagnosis belongs to the ICD-10, the international classification of diseases, the proof of a dementia syndrome (Memory impairment, at least one other cognitive impairment, impairment relevant to everyday life) as well as extensive diagnosis of exclusion.

For the early diagnosis of dementia syndrome, neuropsychological tests like the M.ini-M.ental-S.act-E.xamination (MMSE) suitable. The test covers a total of 11 units in 10-15 minutes that examine the functional areas of orientation, memory, language, reading, writing, arithmetic, practice, cognition, spatial thinking and attention. A maximum of 30 points can be achieved. The range between 18 and 24 points shows a slight dementia, moderate dementia can be diagnosed with points between 10 and 17 and with severe dementia the points achieved are below 10.

The tomography examination using computer or magnetic resonance tomography (CT and MRT) shows a typical image with shrinkage in people with Alzheimer's disease (atrophy) of the brain, especially in the area of the frontal, temporal and parietal lobes with enlargement of the cavities filled with brain water (nerve water) (Ventricle). Imaging is important to rule out other causes of dementia syndrome. A relatively new procedure (PET = positron emission tomography) can show an altered energy metabolism in the affected areas of the brain. The PET documents the reduced consumption of glucose in the frontal, temporal and parietal lobes. The EEG is either uncharacteristic or has a slowed down basic rhythm.

Read more on the topic: Positron emission tomography

The analysis of? -Amyloid or? -Protein in the cerebrospinal fluid can help to confirm the diagnosis of Alzheimer's disease.

A blood test can reveal the presence of metabolic disorders, vitamin deficiencies, infectious diseases and excessive alcohol consumption.

The neurological examination often shows no abnormalities in the early stages and serves to delimit other diseases of the brain and nervous system.

Ultimately, the diagnosis of Alzheimer's dementia is a diagnosis of exclusion if the typical symptoms are present and there is evidence of shrinkage processes in the brain using cross-sectional imaging methods in the absence of findings that suggest another cause of the dementia. Therefore, in order to clarify dementia, extensive exclusion diagnostics have to be carried out. Ultimately, however, the diagnosis of Alzheimer's disease can only be proven in an examination of brain specimens after the death of the person affected, in which deposits of the relevant proteins can be detected far beyond a certain level.

In summary, the following is important for the clinical diagnosis:

Memory deterioration

Impairment of other cognitive functions, e.g. Language function, perception, spatial orientation

Creeping onset and slow progression

Rule out other causes of dementia

Differential diagnosis of Alzheimer's

It is important to differentiate Alzheimer's disease from other causes dementiawhich may be more easily treatable causally. These include, above all, circulatory disorders of the brain (second most common cause of dementia), infections, storage diseases (e.g. Wilson disease), Vitamin deficiency, alcoholic-toxic dementia and other brain diseases such as the Parkinson's disease. Sometimes there are also relatively large areas of overlap in the symptom pictures of Alzheimer's dementia and depression.