Almost all the symptoms of Alzheimer's disease -- depression, wandering, paranoia, belligerence, eating problems, driving problems, grooming problems, incontinence -- can also occur in a number of other so-called "dementing diseases."
As a result, it is difficult to know for sure whether someone has Alzheimer's or some more easily treated condition.
Specialists at the NIH Consensus Development Conference on diagnosing dementias last week recommended several crucial questions for the physician to ask about a patient brought in for analysis of dementia: Is the dementia of sudden onset and rapid progression? This might suggest the possibility of Creutzfeld-Jacob disease, a brain deterioration caused by a virus. Is the progress of the dementia in sudden little steps, with small recoveries in between? This might suggest the possibility of multi-infarct dementia, a series of tiny strokes. Is the progress of the dementia gradual, over a period of time? This process is more suggestive of Alzheimer's disease.
The panel also recommended: An assortment of mental tests, to be administered by the physician, with follow-up interviews to determine whether or how the dementia is progressing. An assortment of endocrinological blood tests.
The panel did not recommend high-tech imaging techniques such as CT or MRI scans as routine in screening dementia patients, but recommended they be reserved for individual cases where there is other evidence pointing to their usefulness.
The panel, concerned about a possible overdiagnosis of Alzheimer's disease, warned that memory test scores must be measured against the patient's education, initial state of intelligence, age, ethnic or cultural group and especially, how much the patient has changed in functioning from his or her former status.