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Diagnosing Alzheimer’s: What to do when you notice cognitive changes in your loved one

How the Alzheimer Society of Simcoe County can help
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When cognitive changes start happening, it can be difficult to figure out what exactly is going on.

Do these changes represent the beginnings of dementia, or could they be the result of a stroke or brain injury? While it’s not uncommon to want to understand the source of the challenges your loved one is experiencing, the first step is to reach out—and the earlier, the better.

While Alzheimer’s disease is the most common type of dementia, there are several other types that could be at play. The Alzheimer Society of Simcoe County provides services and support regardless of the type of dementia a person is experiencing.

Village Media sat down with Laura-Lynn Bourassa, Manager of Education and Support Programs at the society, to talk about warning signs, some of the causes of thinking and memory problems, and where to go for help.

VM: At what point do you recommend patients or concerned family and friends reach out for guidance? Are there specific markers or behaviours that would signal it’s time to check things out?

LLB: There is no one specific behaviour or marker that would signal it’s time to check things out, rather there are several warning signs. The main thing to consider is if the change in behaviour, skill or ability is unusual for a person. Warning signs can include changes in short term memory, language, personality or behaviour.

Once someone starts to become concerned about symptoms, it’s a great time to reach out for guidance. They can engage with their doctor about their concerns, who should then start investigating why these changes might be happening. If they would like some support in these conversations, our staff can review the common symptoms and provide some guidance on how to start the conversation. 

While it may be tempting to avoid getting tested, and receiving a diagnosis is a tough experience, there are some positives to receiving an early diagnosis. These include getting access to treatment, support and education that will help someone live well longer.

VM: How is Alzheimer’s currently diagnosed?

LLB: There is no one specific test that can diagnose Alzheimer’s, so getting a diagnosis may take time.

A doctor will want to investigate all possible causes of the symptoms a person is experiencing to determine if there are any other issues contributing to the changes. They may use medical history, mental status tests, physical and neurological exams, diagnostic tests and brain imaging to narrow down a diagnosis. You may also be referred to a specialist.

VM: What are the typical tests and assessments a person can expect?

LLB: This could vary based on the individual and the relationship they have with their physician (e.g., are they well known to their family doctor?). An initial assessment will include a review of a person’s medical history, including the symptoms they are noticing.

It’s really important to be able to speak to why the symptoms are concerning. When did they start, what did you notice, how is this a change, how is it impacting your daily life, and do others in your life notice the changes as well?

The initial assessment should also include a physical and cognitive exam. During the physical exam, they will be looking for heart, lung, liver, kidney or thyroid problems that may be causing the symptoms, as well as checking out balance and muscle tone. They will also want to do some blood work to check cholesterol, thyroid function and vitamin levels.

The cognitive assessment would involve the administration of a standardized test, like the Montreal Cognitive Assessment (MoCA) or Mini Mental Status Exam (MMSE). These tests measure things like judgement, problem-solving, reasoning and memory.

If the doctor feels like they need more information to make a diagnosis, they may recommend more lab tests and imaging tests like a CT, MRI, SPECT or PET scan to look at the structure of the brain, blood circulating and brain response time.

They may also make a referral to a Geriatrician, Geriatric Psychiatrist or a Neurologist.

VM: What are some of the other conditions that might resemble Alzheimer’s? How are they teased apart?

LLB: Some thinking and memory problems may be improved if the following conditions are treated/addressed: Depression, medication side effects, excessive use of alcohol, thyroid problems and vitamin deficiencies.

VM: How can the Alzheimer Society of Simcoe County help and when, or at what stage, do you recommend patients or caregivers get in touch with you?

LLB: We help by providing services and supports that encourage individuals to live as well as they can with their symptoms or within their role as care partners. We provide navigation help, supportive counselling, support groups, education programs, social recreation programs like Minds in Motion, art & music groups and in-home recreation. We talk with people about issues such as what they are experiencing, how to manage symptoms, caregiving strategies and planning ahead.

We encourage people to get in touch as soon as they receive a diagnosis so the benefits of these services can be felt much sooner and hopefully help people avoid experiencing a crisis.

VM: Are there any misunderstandings or misconceptions about Alzheimer’s that it would be helpful to clear up?

LLB: There are a few. Alzheimer’s is not a normal part of aging; the risk of developing a form of dementia increases as we age but is not a natural part of aging.

It is more than just memory loss. 

Dementia is not a disease that only affects older people. It is more common over the age of 65, but people can be diagnosed with dementia from their 30’s onward. This is called Young-Onset Dementia.

Having someone in your family with dementia doesn’t mean you will get it too. For most people, family genetics do not cause dementia; less then 5% of all people living with Alzheimer’s disease have inherited it from a parent.  

VM: Support and training for caregivers is key too. Are there other local supports or services you would recommend?

LLB: Adult Day Programs can be a really helpful service for many people, both for the person living with the disease and their care partners. We are fortunate to have several great Day Programs in our region. 

Learn more about the Alzheimer Society of Simcoe County or follow the organization on Facebook.

The Alzheimer Society of Simcoe County is dedicated to providing help for people living with dementia and their care partners. They offer programs and services in communities right across Simcoe County.