How Psychiatrists Diagnose Alzheimer's Disease
Although the family's primary care doctor is usually the
first to diagnose or suspect a dementia, often it is a psychiatrist who makes
the formal diagnosis of alzheimer's disease. For example, signs and symptoms of
depression can be very similar to those of dementia. Dementia sometimes has been
mistaken for schizophrenia. For example, hallucinations, delusions and other
bizarre behaviors occur in both severe alzheimer's disease and schizophrenia.
There are other subtle differences between depressed patients and alzheimer
patients that only a psychiatrist may pick up. Patients diagnosed with
depression tend to be more concerned about their memory loss and tend to come by
themselves to the psychiatrist's appointment, whereas demented patients show
less concern about their memory loss, tend to refuse treatments to help memory
loss and usually come to the psychiatrist with their caregiver.
Psychiatrists tend to use the Mini Mental State Exam to
diagnose alzheimer's and dementia. It is a test they use often in diagnosis,
because they are very familiar with it. Once a psychiatrist suspects alzheimer's
or other dementia, the diagnostic focus is on finding what is causing the
dementia. Since more than 100 physical disorders can cause dementia symptoms,
diagnosing the cause is very important. Other tests, such a neurologic exam,
further neuropsychological tests, physical exam and laboratory blood and urine
tests are often ordered to assist in the diagnosis. Psychiatrists sometimes find
dementias that can be reversed. For example, obstructive sleep apnea causes
problems with memory, thinking and attention, like those seen in early dementia.
Yet, when the obstructive sleep apnea is diagnosed and corrected with therapy,
the problems of memory, thinking and attention disappear. Psychiatrists often
correctly diagnose vascular dementia. Psychiatrists use a test called the
Hachinski Scale, which measures signs and sumptoms of vascular dementia. The
Hachinski scale helps the diagnosis vascular dementia. Also useful for diagnosis
are fluctuating memory loss, prior strokes, focal neurologic signs, stepwise
deterioration and preservation of basic
personality.