Diagnosing Alzheimer's - Can doctors know for sure? - By: Gloria Hao Schneider

With the exception of technological advances, the guidelines currently in place for diagnosing Alzheimer's disease have not changed to any degree since 1984 -- before that, only an autopsy could prove with certainty whether a person had Alzheimer's disease.

According to the staff at Mayo Clinic, doctors today can accurately diagnose 90 percent of Alzheimer's cases. The disease can only be diagnosed with complete accuracy during an autopsy, when microscopic examination of the brain reveals plaques and tangles.

Experts proposed new criteria for diagnosing Alzheimer's this week at the Alzheimer's Association International Conference on Alzheimer's Disease 2010. The experts suggest using biomarkers of the disease -- plaques in the brain and specific proteins -- to diagnose Alzheimer's. These biomarkers can be found with MRI scans, PET imaging and tests of cerebrospinal fluid. Specific results would better reflect the various stages of the disease, the scientists say.
To help distinguish Alzheimer's disease from other causes of memory loss, doctors typically rely on the following types of tests.

What to expect:

In addition to a physical exam, your doctor may also check your neurological health by testing your:
" Reflexes
" Muscle strength
" Muscle tone
" Senses of touch and sight
" Coordination
" Balance

During the appointment, your doctor might also conduct a brief mental status evaluation, which may assess:
" Memory
" Problem-solving abilities
" Attention spans
" Counting skills
" Language usage

Lab tests

Blood tests may be done to help doctors rule out other potential causes of the dementia, such as thyroid disorders or vitamin deficiencies.

Neuropsychological testing

Sometimes doctors undertake a more extensive assessment of thinking and memory skills. This type of testing, which can take several hours to complete, is especially helpful in trying to detect Alzheimer's and other dementias at an early stage.

Brain scans

By looking at images of the brain, doctors may be able to pinpoint any visible abnormalities - such as clots, bleeding or tumors - that may be causing signs and symptoms. Positron emission tomography (PET) can reveal areas of the brain that may be less active and the density of amyloid plaques.

" Magnetic resonance imaging (MRI). An MRI machine uses radio waves and a strong magnetic field to produce detailed images of your brain. Patients lie on a narrow table that slides into the tube-shaped MRI machine, which makes loud banging noises during scans. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic in the machine.

" Computerized tomography (CT). For a CT scan, patients lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. The test is painless and takes about 20 minutes.

" Positron emission tomography (PET). During a PET scan, patients are injected with a low-level radioactive material, which binds to chemicals that travel to the brain. You lie on a table while an overhead scanner tracks the radioactive material. This helps show which parts of your brain are not functioning properly. The test is painless and can be particularly useful in distinguishing between different types of dementia.

Caring for patients with dementia or Alzheimer's disease is a complex and consuming task.

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About the Author

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