Alzheimer's disease (Home) | Treatment
By Oluwasola Samuel, Freelance health writer. Medically reviewed by: A. Odutola, MB. BS., PhD, FRCSEd.
An elderly African woman receiving comforting support from a caregiver Image credit: Freepik
To make a diagnosis of Alzheimer’s disease, your doctor may ask you for information about your health and how you carry out your daily activities. Your doctor may also ask your caregiver or family and friends about your symptoms and how you are coping.
While at it, your doctor will try to get information about the following:
After these, your doctor will carry out a comprehensive physical and mental status examination on you. At the end of the history and physical examination, your doctor may have reasonable grounds to diagnose Alzheimer's disease.
Your doctor may then request that you undergo additional diagnostic tests that include the following:
A blood test will be carried out to spot and rule out other potential causes of memory problems. Blood tests can help detect and measure the levels of amyloid and tau proteins. This will guide your healthcare professional on how to treat you or your loved one.
This test is carried out to check your mental status, including your ability to reason, think take decision, plan, organise and perform a variety of higher order executive functions.
The cognitive and memory tests may include:
Your healthcare professional conducts this test to check for any cognitive impairment. This test is question and performance-based, and is targeted at assessing the level of your memory, attention, language, and problem-solving abilities. For example, your healthcare professional may ask you to remember a list of words or perform a simple task.
This test can be used to track how severe Alzheimer's disease is in you.
This test is similar to MMSE, but it is more detailed. This test also evaluates cognitive function to help detect memory decline or issues affecting your brain. Similarly to MMSE, your healthcare professional asks questions and requests performances to check your memory, attention span, and language skills.
The clock drawing test is simple and it is usually incorporated in the Mini mental status and MOCA tests.
Your healthcare professional will ask you to draw a clock showing a specific time. Whatever the result of this simple test is, it can reveal issues with your higher order cognitive functions.
For example, if a person with cognitive decline is asked to draw a clock, the person might struggle with drawing the circle of a clock, writing the numbers in the correct order, or placing the hand of the clock correctly.
These errors may indicate issues with drawing, visual and space orientation, attention, decision making and thinking. These problems are not uncommon in people with Alzheimer's disease.
Please note that the clock drawing test isn't enough to diagnose a person with Alzheimer's disease, but it is a useful tool that can be combined with other tests to help assess a person's cognitive function.
Some people have genes that increase their risk of Alzheimer's disease. As a result, genetic testing may be recommended if the person has a strong family history of this condition.
This test examines the cerebrospinal fluid (CSF) around your brain and your spine. The cerebrospinal fluid flows around your spinal cord and your brain. To obtain the fluid for testing, a special sterile needle is inserted into your lower back and the fluid is collected in a small tube and sent for analysis. The test is able to detect among others, if you have infectious germs affecting your brain, check for biomarkers of Alzheimer’s disease (i.e., amyloid and tau protein), as well as check for substances that may indicate auto immune diseases of the brain, etc. The lumbar puncture test provides information and reflects what's happening in your brain.
Brain imaging helps to provide clear visuals of your brain. This image helps to check for specific changes that might suggest Alzheimer's disease.
The most common brain imaging tests performed in suspected cases of Alzheimer’s disease are:
This is a specialised X-ray machine that provides a picture of your brain. It shows if there is any damage or usual changes in our brain. The CT scan can also be used to detect other issues like stroke or tumours that may cause memory problems.
An MRI test is used to check for abnormalities like shrinking that may be caused by Alzheimer's disease. It shows detailed images of your brain, helping your healthcare professional see any abnormalities that might be caused by Alzheimer's disease.
This test examines or checks how active different parts of your brain are. If you have Alzheimer's disease, some parts of your brain can be less active than others due to nerve cell breakdown. PET scan can also detect abnormal proteins like amyloid or tau that are present in the brains of people with Alzheimer's disease.
A combination of all these tests will help your healthcare professional accurately diagnose and rule out other possible causes of cognitive decline, and provide you with the right care and treatment.
In Africa, diagnosing Alzheimer's disease can be challenging due to several factors that include:
In many African communities, people with mental health-related issues are often seen as bewitched or cursed by a supreme god. As a result, a person with Alzheimer's disease may be isolated. This makes it difficult for such a person and family members to open up or seek help. When people are ashamed to talk or seek help, it delays diagnosis and proper care.
Many people in Africa don't know what Alzheimer's disease is or the symptoms to watch out for. When elderly people show signs of forgetfulness or memory loss, people often associate it with the normal part of ageing. As a result, family members don't seek medical help early. They think nothing can be done to salvage the situation.
There is a shortage in most sub-Saharan Africa countries of healthcare professionals like neurologists (a doctor who specialises in diagnosing and treating conditions that affect the brain, spinal cord, nerves, and muscles), geriatricians (a doctor who specialises in treating older people), and psychologists (a professional who studies and analyses how people feel, think, and behave) who can diagnose and provide proper care to manage your symptoms,
Without enough specialists on the ground at health facilities to diagnose and treat Alzheimer's disease, general duty doctors may miss the early signs or confuse Alzheimer's disease with other illnesses like depression or stroke.
There are limited healthcare facilities in many rural areas that are equipped sufficiently to diagnose Alzheimer's disease accurately. Even in urban areas, specialised facilities are also limited. This means people with Alzheimer's disease will have to travel long distances to diagnose their condition and get proper care. This can be time-consuming and expensive for many.
To diagnose Alzheimer's disease, expensive tools like CT scans, MRI scans, and blood testing equipment will have to be used. The cost of diagnosing a person can be quite expensive as a result. In most cases, families prefer to use their money to cater for their basic needs (food, clothing, school fees) over medical tests.
Many families may also think that if diagnosing a condition is expensive, treating the condition will also be expensive. Instead of going for modern hospital based treatment, they would opt for local or traditional alternatives.
In many African communities, diseases like malaria, HIV, and tuberculosis are considered urgent because of the casualties involved. This causes Alzheimer's disease and other related conditions to get less attention than they deserve. For example, many local and urban healthcare facilities that only have resources to treat malaria or tuberculosis will likely not invest their resources in training staff or sourcing tools to diagnose and treat Alzheimer's disease and other related conditions.
A health record helps to track or monitor a person's health history. This gives your healthcare professional a better understanding or view of your condition. However, many healthcare systems in Africa lack reliable data records.
If you visit different clinics without your health record moving with you, the healthcare professional might diagnose something different. This wrong diagnosis can be avoided if reliable data records are safely stored and available with due care to any provider that you see.
Some people avoid visiting their healthcare professionals out of fear of “bad news” or lack of trust in the healthcare system. They may decide to see if the condition gets better. As a result, this delays early diagnosis and makes it harder to provide effective care.
All these challenges explain why many are undiagnosed and why many families are left to manage the condition without proper support.
Solving these challenges requires improving access to affordable healthcare, increased awareness about this condition, proper education, and investment in the care of Alzheimer's disease and other related conditions.
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Resources
Related:
Dementia: What Africans should know
10 things Africans should be doing to lower dementia risk
Published: December 4, 2024.
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