When Alois Alzheimer was working with demented patients in Frankfort, Germany around 1900, he had an interesting patient called Mrs. Auguste D. Her behavior was bizarre and her memory loss was significant. When he coaxed her to write her name, she could not do it though she tried. She looked into Alzheimer’s face and said, “I have lost myself.” This poignant response is still the hallmark of Alzheimer’s disease. We don’t know Mrs. Auguste D’s background, nor when her mental problems began; at the time she was 51 years of age. We do know that Dr. Alzheimer’s interest in her caused him to devote the next five years to studying her case and to discover what remains today to be known as the underlying condition in the brain of an Alzheimer’s patient – the presence of amyloid plaques and neurofibrillary tangles.

Since he delivered his famous lecture on the subject in l906, and published a paper in l907, much research has contributed to the work of discovering what causes these aberrations in the brain. It is true that absolute diagnosis of the disease is not possible without an autopsy. However, the disease can be 95-100% accurately determined with thorough and competent diagnostic procedures.

The Alzheimer’s Association has provided excellent guidance in this area, as has the Mayo Clinic. I will share from these sources and from my experience, with the reminder that no two people would ever need exactly the same process and procedures. Each case is unique with differing genetics, medical histories and current health challenges.

Consider these elements:

1. Observe the loved one and make mental notes of changes, especially if they seem to be worsening.

2. Educate yourself on the warning signs of Alzheimer’s disease. See the Alzheimer’s Association’s “10 Warning Signs of Alzheimer’s Disease” on this web page. Also talk with trusted friends who have had family members with the disease.

3. Get an assessment by a medical doctor who can help sort out whether the signs of dementia are caused by a reversible and/or treatable condition such as dehydration, thyroid problems, vitamin deficiency, reaction to medications, other diseases, etc. The Alzheimer’s Association of Middle Tennessee classifies these conditions as:

Consumptive related causes: dehydration, alcohol, caffeine, nicotinic acid, and medication including over the counter drugs and interactions.

Stimulus/ sensory deprivation: sensory impairments such as hearing or vision loss.

Psychosocial issues: losses such as people, job, role, memory, function; changes in social dynamics; depression and anxiety.

Treatable medical causes of reversible confusion: pain , infection, cardiovascular disturbances, metabolic challenges, nutritional deficiencies, post operative reactions, and others.

4. See specialists as recommended for mental status tests to determine various cognitive functioning levels of the brain including recall, judgment, comprehension, and abstract thinking.

5. Undergo laboratory tests, as recommended , including electroencephalograph (EEG), CT scan, MRI, EKG, etc. Some neuroimaging can show changes in the structure and functioning of brain circuits.

We should never assume a person has Alzheimer’s because he/she displays a few symptoms that we associate with the disease. It’s highly important to find out! The option of early treatment, if it is Alzheimer’s, is good; the option of reversing a condition mimicking Alzheimer’s is even better. Either way, results can be positive.