Diagnosing Alzheimer's: Medical History

Reviewed by: HU Medical Review Board | Last reviewed: June 2019 | Last updated: March 2023

When a person suspects they might have Alzheimer’s, or if a medical professional suspects Alzheimer’s disease, getting an accurate diagnosis is crucial. There are a variety of ailments that can mimic the neurological symptoms of Alzheimer’s disease, and those ailments should be ruled out in order to find the actual cause of the symptoms. Alzheimer’s disease can only be definitively diagnosed after death, with tissue from an autopsy; while a patient is living, the diagnosis is made from a constellation of tests, observations, and lab work.1 There is research currently being done to find ways of definitively diagnosing Alzheimer’s disease earlier, but this is still in process.

There is no single diagnostic test for Alzheimer’s disease, so a doctor uses a variety of things to make a diagnosis. One of the tools a physician uses to help them diagnose Alzheimer’s disease is a medical/symptom history.

Symptom history of Alzheimer’s disease

One of the questions the doctor will ask is if the person is experiencing any symptoms of Alzheimer’s disease. The doctor will be looking for symptoms that are more severe than the normal signs of aging, depending on the person’s age and education.2 Symptoms can include things like memory impairment, trouble problem-solving or planning, getting lost or confused easily, “losing” time or becoming confused about the passing of time, visual-spatial difficulties, language problems, poor judgment or decision-making, social withdrawal, and mood changes.3 Not only will the doctor see what symptoms are present, but also the frequency and severity of the symptoms. If symptoms have gotten progressively worse, that’s important for the doctor to know. Having one or more of these symptoms does not necessarily mean a person has Alzheimer’s, but it can give the doctor clues and insight as to what might be going on, and what other tests to run.

Medical history of Alzheimer’s disease

The medical history consists of written and/or verbal questions about past illnesses, current illnesses, any medication or drug use, alcohol consumption, and family medical history. Even things that might not seem relevant can give the physician important clues as to what might be causing the symptoms. It is often helpful for the patient to bring along a close family member or caregiver. Not only does this provide added support for the patient, but the doctor can then ask them questions about symptoms, behavior, and medical history – which is especially important if the person cannot remember their medical history or is an unreliable reporter.

Ruling out other conditions

Because symptoms of Alzheimer’s disease, especially in the early stages, are similar to other neurological diseases or other ailments, it’s important to rule out any other possible explanation for the symptoms. Possible differential diagnoses can include other forms of neurocognitive disorders, medication interactions, adverse drug effects, stroke, brain tumor, or hemorrhage.3 The treatments for each underlying cause vary widely, and so it’s imperative to get an accurate diagnosis.

Other tests

A medical/symptom history is just one part of the diagnostic process for Alzheimer’s disease – although it’s an important one. Based on the information the doctor gathers from these histories, they will decide on other tests like lab work to assess for thyroid issues of vitamin deficiencies, brain imaging tests, and neurological and neuropsychological tests.

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