Alzheimer’s disease (AD) is the most common neurodegenerative disease and yet it is still difficult to diagnose. Although there are more and more tests/techniques that help us in the diagnosis, without being aggressive or less than brain biopsy. In our center we have the necessary professionals to make an early diagnosis and prescribe the appropriate treatment, monitoring the entire process.
Diagnosis of Alzheimer’s disease
In neurology, the diagnosis of Alzheimer’s disease is based on studying the patient’s clinical history, performing neuropsychological tests that demonstrate a “typical” cognitive impairment, which can help us differentiate the type of dementia; a blood test and an imaging test, ideally a brain Magnetic Resonance Imaging (MRI) to rule out other causes of dementia and to know if there is brain atrophy. Brain perfusion SPECT or brain PET with FDG is also sometimes used.
Based on the results of these tests, the diagnosis is based on probability, divided into two categories: probable AD and possible AD, and sometimes a brain biopsy is performed. Despite the use of these techniques, the diagnosis is not entirely reliable, although fortunately this situation is currently changing.
Another method that helps us is lumbar puncture (LP), which measures the amount of certain proteins (Beta-amyloid and Tau) in the cerebrospinal fluid (CSF). As it is an uncomfortable test, although with few risks, it is rarely performed, since it should ideally be done while the patient is hospitalized.
New developments in the diagnosis of Alzheimer’s disease
The new diagnostic innovations that have just arrived in Spain are the new PET tracers for AD only. This procedure focuses on cerebral Beta-amyloid, an abnormal protein that appears in the brain of AD patients, although not only in them.
If the result is negative, it is very unlikely that the patient has AD. If it is positive, and the rest of the tests also support the diagnosis, it is more likely that the patient has an AD, improving the specificity and sensitivity of the diagnosis although without quantifying it.
Despite advances, at present we cannot know with absolute certainty whether or not we have AD. Its early diagnosis is important, because although today it is a disease that has no cure, it does have treatment to reduce its progression.
And as important as the previous ones, is cognitive rehabilitation. That is to say, to practice exercises and specific intellectual activity, and a healthy lifestyle with control of vascular risk factors such as blood pressure, sugar, cholesterol, tobacco and daily exercise.