Getting a Diagnosis

I still get irritated when I think about how our family doctor dismissed our concerns and delayed our getting a diagnosis regarding Alzheimer’s for my wife.  We knew as a family that Kristie was clearly showing signs of memory loss, and our two daughters pleaded with me to request testing when we went in for physical exams - which I did.  Our doctor, however, was fixated on Kristie getting a colonoscopy and mammogram since there was a 5% chance of colon cancer and a 10% risk for breast cancer.  Never mind that early-onset Alzheimer's ran in Kristie’s family (her father, grandmother, great grandmother, and so on back 5 generations), and there was a 50% chance she could inherit this gene.  I informed our doctor of the family history with Alzheimer's and the troubling signs we were seeing.  He briefly spoke with Kristie but said he didn’t feel additional testing was needed. 

When we went back to talk about the results from Kristie’s colonoscopy and mammogram, I again requested she be tested for memory loss.  This time he asked Kristie two or three questions, and then said he didn't think additional testing was warranted.  I didn't push it because it almost looked like I was the problem, and that I was trying to create fear in my wife regarding Alzheimer's.

Our daughters were alarmed when they came to visit six months later, and mad with me that I hadn't pushed for additional testing.  Finally, our youngest daughter who was 900 miles away at college, called our doctor's office long-distance and spoke with a nurse, explaining all the signs we were seeing and while crying, asked how her mother could get tested.  The nurse informed her that the patient had to request the testing themselves, which really seemed strange.  Nevertheless, after our daughter called with this information, we went down to our doctor’s office the next day and said Kristie wanted to be tested for Alzheimer's. 

We were given an appointment for a month later, where I spoke again about Kristie's memory problems.  Our doctor took the time to ask Kristie ten standard questions.  She was only able to answer half of the questions - like the state we were in and what month it was.  The doctor then said he really didn't feel additional testing was necessary, but he would oblige us since we were so concerned.

It took a couple months to start cognitive testing, and then there was a delay after the first two appointments due to a family trip and Kristie missing her appointments because she had such an aversion to being asked so many questions which made her feel dumb.  The testing results four month later, however, indicated an obvious problem and so a referral was made to a neurologist - for three months later.  Finally, a year and a half from when we first requested testing, we met with a neurologist who readily diagnosed Alzheimer's based on the results from the cognitive testing.  She referred us to the Oregon Health Science University where seven months later they conducted genetic testing and determined my wife had the Presenilin 1 gene mutation found in early onset familial Alzheimer's.

From my experience, it can be extremely frustrating when a spouse or family members observe significant memory loss in a loved one and try to get a diagnosis.  Hopefully, the medical community is becoming more aware and helpful to encourage and pursue testing for cognitive memory decline. 

As I encouraged under Warning Signs - it is very helpful to keep a journal and write down whenever you notice a memory lapse or some confusion that indicates cognitive impairment for someone you suspect could been experiencing memory loss.  This will allow you to see better both the progression and extent of disfunction; and allow you to share this information with others if you proceed to get a diagnosis.

*Note - I highly recommend writing down and sharing events and indications of memory problems with counselors and medical personnel in written form, rather embarrassing and demoralizing the person having problems by trying to describe in detail their failings and faulty memory with them listening.  They already feel stupid and recounting all their faux pas in public will only increase their anxiety and distrust in themselves and you.

Your comments or willingness to share related experiences below about Getting a Diagnosis would be helpful and appreciated. 

Resource Links

  • WebMD – Overview of how doctors diagnose dementia.
  • Alzheimer’s Association – Explanation of how Alzheimer’s is diagnosed.
  • BrainGuide by UsAgainsAlzheimer's – Understanding screening, detection, and diagnosis; as well as two memory questionnaires: one to take for yourself, and another for someone you care about. Each questionnaire takes less than ten minutes to complete.
  • Catch It Early - a resource for learning about Alzheimer’s disease, including the earliest clinical stage, mild cognitive impairment (MCI).  Sometimes symptoms can be mistaken for normal aging, but it could be more and worsen over time, and the sooner you catch MCI due to Alzheimer’s the better. 

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