Diagnosis
Early diagnosis is beneficial for several reasons. Having an early diagnosis and starting treatment in the early stages of the disease can help preserve function for months to years, even though the underlying Alzheimer’s Disease process cannot be changed. Having an early diagnosis also helps families plan for the future, make living arrangements, take care of financial and legal matters, and develop support networks.

Alzheimer’s Disease (AD) can be definitively diagnosed only after death by linking clinical course with an examination of brain tissue and pathology in an autopsy. But doctors now have several methods and tools to help them determine fairly accurately whether a person who is having memory problems has “possible AD” (the symptoms may be due to another cause) or “probable AD” (no other cause for the symptoms can be found). To diagnose AD, doctors:

• ask questions about the person’s overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality

• conduct tests of memory, problem solving, attention, counting, and language

• carry out medical tests, such as tests of blood, urine, or spinal fluid

• perform brain scans, such as a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) test

These tests may be repeated to give doctors information about how the person’s memory is changing over time.

Treatments
Currently, there is no cure for Alzheimer’s. But drug and non-drug treatments may help with both cognitive and behavioral symptoms. Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia. Current treatments focus on several different aspects, including helping people maintain mental function; managing behavioral symptoms; and slowing, delaying, or preventing AD.

• Helping People with AD Maintain Mental Function
Four medications are approved by the U.S. Food and Drug Administration to treat AD. Donepezil (Aricept®), rivastigmine (Exelon®), and galantamine (Razadyne®) are used to treat mild to moderate AD (donepezil can be used for severe AD as well). Memantine (Namenda®) is used to treat moderate to severe AD. These drugs work by regulating neurotransmitters (the chemicals that transmit messages between neurons). They may help maintain thinking, memory, and speaking skills, and help with certain behavioral problems. However, these drugs don’t change the underlying disease process and may help only for a few months to a few years.

• Managing Behavioral Symptoms
Common behavioral symptoms of AD include sleeplessness, agitation, wandering, anxiety, anger, and depression. Scientists are learning why these symptoms occur and are studying new treatments—drug and non-drug—to manage them. Treating behavioral symptoms often makes people with AD more comfortable and makes their care easier for caregivers.

• Slowing, Delaying, or Preventing AD
AD research has developed to a point where scientists can look beyond treating symptoms to think about addressing the underlying disease process. In ongoing AD clinical trials, scientists are looking at many possible interventions, such as cardiovascular treatments, antioxidants, immunization therapy, cognitive training, and physical activity.

• Supporting Families and Caregivers
Caring for a person with AD can have high physical, emotional, and financial costs. The demands of day-to-day care, changing family roles, and difficult decisions about placement in a care facility can be hard to handle. Researchers are learning a lot about AD caregiving, and studies are helping experts develop new ways to support caregivers.

Becoming well informed about AD is one important long-term strategy. Programs that teach families about the various stages of AD and about flexible and practical strategies for dealing with difficult caregiving situations provide vital help to those who care for people with AD.

Developing good coping skills and a strong support network of family and friends also are important ways that caregivers can help themselves handle the stresses of caring for a loved one with AD. For example, staying physically active provides physical and emotional benefits. Some AD caregivers have found that participating in an AD support group is a critical lifeline. These support groups allow caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. The Alzheimer’s Association, Alzheimer’s Disease Centers, and many other organizations sponsor in-person and online AD support groups across the country. There are a growing number of groups for people in the early stage of AD and their families. Support networks can be especially valuable when caregivers face the difficult decision of whether and when to place a loved one in a nursing home.

Clinical Trials
Early diagnosis can also provide greater opportunities for people to get involved in clinical trials. In a clinical trial, scientists test drugs or treatments to see which are most effective and for whom they work best. People with AD, those with MCI, those with a family history of AD, and healthy people with no memory problems and no family history of AD may be able to take part in clinical trials. Study volunteers help scientists learn about the brain in healthy aging as well as what happens in AD. Results of AD clinical trials are used to improve prevention and treatment approaches. To find out more about AD clinical trials, talk to your health care provider or contact the National Institute on Aging’s ADEAR Center at 1-800-438-4380 or, visit the clinical trials database.

Advancing Our Understanding
Thirty years ago, little was known about about AD. Since then, scientists have made many important advances. Research supported by NIA and other organizations has expanded knowledge of brain function in healthy older people, identified ways to lessen normal age-related declines in mental function, and deepened understanding of AD. Many scientific and clinical fields are now working together to untangle the genetic, biological, and environmental factors that, over many years, ultimately result in AD. This effort is bringing us closer to the day when we will be able to manage successfully or even prevent this devastating disease.

For More Information
To learn about support groups, services, research centers, research studies, and publications about AD, contact the following resources:

Alzheimer’s Disease Education and Referral (ADEAR) Center
P.O. Box 8250
Silver Spring, MD 20907-8250
800-438-4380 (toll-free)

Alzheimer’s Association
225 N. Michigan Avenue, Floor 17
Chicago, IL 60601-7633
800-272-3900 (toll-free)
866-403-3073 (TDD/toll-free)

Alzheimer’s Foundation of America
322 Eighth Avenue, 7th Floor
New York, NY 10001
866-AFA-8484 (866-232-8484; toll-free)