Diagnosing the Alzheimers

My mother was in her early 70's when she started expressing distress over forgetting words. Her children attributed the few lost words or forgotten names to the normal aging process. Mom was living on her own, driving, serving in her church and still was more help to us than, perhaps, we were to her. She was a "doer" and though quiet and gentle, a strong force in many lives.

By age 75, she worried enough to start pushing to see a neurologist, so I took her in for testing. She did really well on the initial memory test. It was just a series of fairly simple questions and she did well enough that the doctor didn't seem overly concerned. He ordered blood tests and a CAT scan just in case there was some other physiological reason for the the forgetfulness. My mom actually hoped she had a brain tumor that could just be surgically removed. What she was saying is that she wanted a definable and solvable affliction as opposed to the ugly, ambiguous, unstoppable Alzheimer's disease.

Her doctor also suggested that she start taking Aricept, a drug that has been somewhat successful in slowing the progression of the disease. He explained that they start on a low dosage and if she tolerated it well they would increase the dosage. Meanwhile we would get the tests done and see what could be done. The blood tests came back normal. The CAT scan showed some abnormalities in the brain, but nothing definitive or significant. The notes from the radiologist mentioned the abnormalities but said they could be results of normal aging. My mom was disappointed that there was nothing obviously wrong.

She started taking the medicine. I'll write about that in another post.

About a year later, as my mom insisted that she was getting worse (and I concurring), the doctor ordered a PET scan and a session with a neuro-psychiatrist. The PET scan was read as showing "symptoms that are consistent with Alzheimer's." The neuro-psychiatrist confirmed that there was some forgetfulness but said she was not significantly progressed. I was unimpressed with his observations. It certainly seemed to me that a lot more was going on than he assessed.

And then things started to go down hill fast.