Examinations and Diagnosis of Alzheimer Disease


Examinations and Diagnosis of Alzheimer Disease

How to diagnose Alzheimer disease? Alzheimer disease can be diagnosed through clinical examinations.

Clinical diagnosis

According to medical history and psychiatric examinations, doctors can judge if patients suffer from Alzheimer disease.　

Neuropsychological tests
Mini-mental state examination(MMSE): It is conscious in contents and short in testing time, so it is more easily accepted by the aged. It is the most common scale for testing the degree of intellectual damages of this disease in clinic.
The total score of this scale is related to the educational degrees. If the scores of an illiterate person≤17; the scores of people with primary educational degree≤20; the scores of people with secondary education level ≤22; the scores of people with university education level ≤23, these mean that there exists cognitive impairment.

Activities of daily living assessment
ADL assessment scale can be used for evaluating the degree of harm of activities of daily living of patients.
This scale includes two parts: The first is physical self-maintenance scale, which is to test patients’ ability to take care of themselves (such as dressing, taking off clothes, combing hairs and brushing teeth ); the second is instrumental activities of daily living scale, that is to test patients’ ability to use daily living instruments (such as making a telephone call, taking a bus and cooking for themselves)

Behavioral and psychological symptoms of dementia assessment
It includes behavioral pathology in Alzheimer disease (BEHAVE-AD), Neuropsychiatric Inventory and Cohen-Mansfield, and requires the information baseline provided by the insiders. These scales can not only find symptoms, but also can evaluate the frequency of symptoms, serious degree and the burden causing to caregivers, conduct repeated assessment and monitor the treatment effects.

Blood test, examinations on neuron system, electroencephalogram, CT examination and brain MRI

Blood tests
It mainly used for detecting existing accompanied diseases or complications, potential risk factors, and excluding dementia caused by other diseases. Blood tests include blood routine examinations, blood sugar and blood electrolytes including blood calcium, kidney functions and liver functions, vitamin B12, colic acid level and thyroid hormone. High risk population or population showing clinical symptoms shall conduct serologic examination of syphilis, human immunodeficiency virus and borrelia burgdorferi.

Examinations on nervous system
These examinations are used for excluding other potential diseases and detecting specificity of imaging findings of Alzheimer disease

Functional neuroimaging
For example, positron emission tomography and single photon emission computed tomography can improve the diagnostic reliability of dementia.

EEG
EEG can be used for differential diagnosis of AD, provide the early evidence of prion disease or suggest the possibility of toxic- metabolic disorder, transient epileptic amnesia or other epileptic diseases.

CT examination (thin slice scan)
In the CT diagnosis of diffuse cerebral atrophy, temporal lobe and hippocampal atrophy and expansion of inferior horn ( transverse diameter＞7.7mm) are helpful for differential diagnosis of AD patients and normal cerebral aging.

Brain MRI
Brain MRI can provide the updated diagnosis information of changes of brain structure. Through MRI, it can be found that the size of anterior temporal and hippocampal formation of patients with AD is obviously smaller than that of control group. Using MRI to test the atrophy degree of the middle structure of temporal lobe so as to distinguish patients with AD and the control group of the same age. Its sensitivity is 81.0% and the specificity is 67.0%.

In terms of differential diagnosis, attentions shall be paid to conducting differential diagnosis with dementia caused by vascular, vitamin B deficiency, pernicious anaemia, neurosyphilis, normal pressure hydrocephalus, brain tumor and other primary lesions of brain such as Pick diseases and Parkinson’s disease. Moreover, attentions also shall be paid to conducting differential diagnosis with pseudodementia and delirious caused by depression.







评论

发表评论

此博客中的热门博文

Symptoms of Cerebral Palsy

图片
Symptoms of Cerebral Palsy Symptoms of cerebral palsy are more obvious in newborn babies but parents tend to think that these symptoms are simple slow development, eventually missing the best treatment time. Parents shall take a look and carefully understand symptoms of cerebral palsy. Main symptoms of cerebral palsy 1. Movement disorder When moving, their hands and feet are not coordinated and they are physically weak. Patients can’t grasp objects with their hands, can’t walk with feet, even are unable to roll over, sit up or stand and can’t chew or swallow normally. 2. Disorder of gestures Patients have gesture abnormalities and poor posture stability and still can’t raise head straightly when they are three months old. Head tends to lean on one side or sways back and forth. Patients are unable to turn over when six months old and can’t sit steadily. Children with cerebral palsy don’t like bath and it is difficult to break their fist apart when washing...
阅读全文

Hangzhou stem cells donator becomes online celebrity

图片
Hangzhou resident Xu Aifei, 28, became an internet celebrity after donating stem cells and writing about her experience online, while also giving other donators peace of mind. Xu donated stem cells on September 12, 2017, and recorded her experience on her Weibo microblogging account on Saturday. The post has garnered over 120,000 likes and nearly 40,000 reposts. “Stem cell donation is a once in a lifetime experience that few people have,” she said. Xu has been donating blood since she was in senior high school, having donated a total of 3,200 ml. In 2009, while donating blood, she read a leaflet on stem cell donation and learned that it is not as painful as she had thought, so she decided to do it. Later that year, she joined the Chinese Marrow Donor Program. On May 7, 2017, she received a call and was told that her stem cells matched a patient. Without hesitation, Xu agreed to donate her stem cells to save a 15-year-old boy with leukemia. Xu wrote on her Weibo acco...
阅读全文

Stem cell anti-aging

图片
Why do we age  and how we can stop it Aging is a complex process in which stem cells and fibroblasts are progressively damaged by stress, nutrition, and lifestyle, until they finally die.  Eventually, your body loses its ability to heal properly and some chronic problems may occur, especially with the kidney, liver, and digestive tract.  These problems can affect not only your energy, vitality, sex drive, and sleep quality, but also the apparent health of the skin on your face, neck, chest, and hands. Declining functionality of the fibroblasts can also lead to poor collagen level, wrinkles, and saggy dry skin.  - By the age of 35, your cell production rate drops by 45 percent. - At 50, your cell production rate is cut in half. - By the time you've reached 65, cell production rate is down by a whopping 90 percent. How to treat the core causes of aging One of the most common ways to get rid of visibly aging skin is plastic surgery. H...
阅读全文