Mailbox Response
The question was submitted
18/03/2008
Subject: 2nd opinion
My mother was diagnosed with Alzheimer's today. However, no one in our family, including myself believes it is that. I promise its not denial, its just that not everything fits is all. Three years ago she fell in a super market and ended up with a very bruised elbow and a knot on her forhead the size of a large egg. Her neurologist she has gone to for the last 3 years has just diagnosed her with Alzheimers but he has not done the new blood test I am told is out now days.
She has problems with memory true enough but her biggest problem is comprehending what you say to her, she asks 'what' or says 'huh?' a fair amount of the time but then the next minute she understands everything you say. She has been like this for a few years now. At first we thought it was her hearing but she says thats not it. Another big thing is that when she reads or some times just says a sentence she absolutely slaughters some of the words. Not every time she reads or says something though. Like the word Hydroginated, I have a better chance of winning the lottery than she has of ever correctly pronouncing that word. Her general practitioner prescribed a B-12 shot for her but we noticed only a little improvement for a few days and then back to the way she was.
One last thing...occassionally she will call me and ask for directions on how to get from someplace in the heart of town to our house. We've lived in Aiken for 15 years. My dad said this happened years ago when we lived in Florida but then went away...again, it ws a town we had lived in for years. This cannot be a coincidence.
We are seaking a second opinion for her diagnosis simply because the doctor has taken so long to finally reach this conclusion...in 3 years her condition has not gotten so much worse that he would just all of the sudden come to this conclusion now. Does this sound like Alzhiemers or any other type of dementia to you? I know you don't have her medical records in front of you...but call this a hypothetical scenerio and tell me what you think...PLEASE!
Thank you so muchfor taking the time to read this lengthy email...I appreciate it and your feedback SOOOO much.
Jaime Smedley
Answer from DementiaNet
It does seem that your mother has an altered mental state and Alzheimer’s (AD) needs to be considered in this situation. It is often difficult for a doctor to make a diagnosis at the first visit as the diseases that cause dementia are often subtle and take a few years to emerge into a recognizable disease. The diagnosis of AD should be based on three things 1. Detailed information from patient and family, 2. Memory testing, it may be necessary to get a neuropsychologist to do this, 3. An image of the brain, usually an MRI is needed. The diagnosis cannot be done with any certainty without all of these completed. There is no blood test available at present that can make the diagnosis. There are a number of other brain diseases that have a different presentation to AD and these can often be distinguished with the approach mentioned above. It is reasonable for you and your mother to ask for an explanation from the neurologist as to how the diagnosis was made. Obtaining a second opinion from a memory clinic specialist (a geriatrician or psychiatrist) is also a worthwhile exercise. Your mother’s GP will know where the closest memory clinic is.
The answer was published on DementiaNet
19/03/2008