At the early stages when symptoms first appear, it is important that a proper medical evaluation be completed to establish whether there is dementia and, if so, what is the precise diagnosis. Only then can the proper management protocol be initiated. Although at this time there is no cure for AD, confirming the diagnosis leads to specific management plans to enhance living conditions for both the patient and the family. Patients showing signs of early dementia require a careful and complete medical assessment by a primary care physician. In addition to a detailed history, a thorough physical examination is necessary to determine any other abnormalities which may account for the symptoms. Discussion with a family member or close friend is important to get an objective view of the signs and symptoms which the patient is experiencing, such as impaired memory, changes in personality, periods of confusion and forgetfulness. Other health conditions such as Parkinson’s disease, depression, strokes, sleep apnea and mild memory loss common with normal aging will be ruled out. The doctor or assistant might administer one of several cognitive tests available which assist in confirming the presence of dementia. If there is still doubt, neuropsychological tests can be administered by a trained specialist to further determine the extent of dementia. Most cases of AD can be confirmed with the evaluation described but, in some cases, the physician will order a brain scan to assist in diagnosing AD as well as to rule out other causes such as stroke, brain hemorrhage and brain tumour. The scan may be an MRI, a CAT scan or a PET scan. Such tests are not conclusive as age-related changes in scans can show similar findings, but can add to the other information to support the diagnosis of AD. Diagnosing the condition at an early stage is helpful not only in ruling out other causes, but also in planning for ongoing care and prescribing medications that may slow the progression of memory loss and decline in cognitive skills. Over-the-counter medications purporting to reverse memory loss and other symptoms should be avoided. Caregivers with expertise in AD can assist with finding access to community resources, arranging activities and relieving spouses and family members who provide constant care. Community resources may include legal and financial planning assistance as well as home care services, including nursing care. If institutional care is eventually needed, most communities have appropriate secure facilities to accommodate persons with advanced dementia. There are several organizations – both provincial and national – that provide vital information to families about AD. In Canada, the Alzheimer Society of Canada (alzheimer.ca) is a leading source for information on dementia. Their mission is “to alleviate the personal and social consequences of Alzheimer’s disease and other dementias and to promote the search for causes, treatments and a cure.” In addition, there are independent provincial societies representing each province including The Northwest Territories, as well as many local societies in most larger communities, all readily accessible on the internet. Most of us know or have known someone with AD and understand the unfortunate toll which the disease takes on both the patient and family members. At this time there is no cure, but significant advances in diagnostic tools have been made and treatments to delay progression of the disease, as well as potential cures, are being actively pursued. Support for research is very much needed and is actively supported through donations to these societies. Health CSANews | SPRING 2025 | 31
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