University Health System Blog

Dr. David Ginsburg answers the question: Alzheimer’s disease: What are the possible early warning signs?

While it may be difficult to diagnosis Alzheimer’s disease with relative certainty early in the disease process, the diagnosis typically becomes more firmly established over time.

Patients initially presenting to a physician with complaints of memory loss may have early Alzheimer’s disease, or may alternatively have a less serious condition called “benign forgetfulness.” As symptoms gradually progress to involve other aspects of cognition, such as problems with word-finding, writing, drawing and calculating, the likelihood of Alzheimer’s disease increases.

These problems become particularly concerning when they interfere with daily functioning, such as working, cooking, self-grooming and balancing the checkbook.

When evaluating a patient with memory impairment, a physician will likely screen for a variety of possible causes, including stroke, tumor, epilepsy, depression, vitamin B-12 deficiency, hypothyroidism and hydrocephalus.

The work-up will likely include a brain CT or MRI, electroencephalography (EEG) and a variety of blood tests. A brain PET scan is also occasionally useful to evaluate for regional areas of metabolic disturbances.

If the diagnosis remains unclear, occasionally the patient will undergo a detailed cognitive evaluation by a neuropsychologist. The neuropsychological evaluation may subsequently be repeated after six to 12 months in order to monitor for worsening of the various subtests, which in turn might suggest a progressive neurodegenerative disorder such as Alzheimer’s disease.

The only way to diagnosis Alzheimer’s disease with absolute certainty is with a brain biopsy, which is not typically performed for this condition.

On the other hand, a diagnosis of Alzheimer’s disease is generally confirmed or excluded to a high degree of accuracy on the basis of the patient’s history, examination and a variety of ancillary tests as previously discussed. The importance of early diagnosis cannot be overstated, as a variety of medications are currently available to treat this condition.

David Ginsburg, M.D. is a neurologist practicing in Las Vegas, Nevada. He is an associate professor of neurology at the University of Nevada School of Medicine.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. David Ginsburg answers the question: “Can a head injury increase my risk for developing Alzheimer’s disease?”

Although head injury has not been clearly proven as a risk factor for Alzheimer’s disease, several studies have suggested an association—particularly in men.

In at least one study, there was evidence that the observed time from traumatic brain injury to onset of Alzheimer’s disease was less than the expected time to onset of Alzheimer’s disease.

In addition, several studies evaluated the correlation between head trauma, the ApoE4 gene, an independent risk factor, and Alzheimer’s disease.

Upon reviewing the medical literature, no uniform conclusions could be determined. The association between head trauma and Alzheimer’s disease remains an active area of research.

David Ginsburg, M.D. is a neurologist practicing in Las Vegas, Nevada. He is an associate professor of neurology at the University of Nevada School of Medicine.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. David Ginsburg answers the question: “Is there a way to detect the onset of Alzheimer’s disease in its early stages?”

While it may be difficult to diagnosis Alzheimer’s disease with relative certainty early in the disease process, the diagnosis typically becomes more firmly established over time.

Patients initially presenting to a physician with complaints of memory loss may have early Alzheimer’s disease or may alternatively have a less serious condition called benign forgetfulness.

As symptoms gradually progress to involve other aspects of cognition, such as problems with word finding, writing, drawing and calculating, the likelihood of Alzheimer’s disease increases. These problems become particularly concerning when they interfere with daily functioning, such as working, cooking, self-grooming and balancing the checkbook.

When evaluating a patient with memory impairment, a physician will likely screen for a variety of possible causes, including stroke, tumor, epilepsy, depression, vitamin B-12 deficiency, hypothyroidism and hydrocephalus. The work-up will likely include a brain CT or MRI, electroencephalography (EEG) and a variety of blood tests. A brain PET scan is also occasionally useful to evaluate for regional areas of metabolic disturbances.

If the diagnosis remains unclear, occasionally the patient will undergo a detailed cognitive evaluation by a neuropsychologist. The evaluation may subsequently be repeated after 6 to 12 months in order to monitor for worsening of the various sub-tests, which in turn might suggest a progressive neurodegenerative disorder such as Alzheimer’s disease.

The only way to diagnosis Alzheimer’s disease with absolute certainty is with a brain biopsy, which is not typically performed for this condition.  On the other hand, a diagnosis of Alzheimer’s disease is generally confirmed or excluded to a high degree of accuracy on the basis of the patient’s history, examination and a variety of ancillary tests as previously discussed.

The importance of early diagnosis cannot be overstated, as a variety of medications are currently available to treat this condition.

David Ginsburg, M.D. is a neurologist practicing in Las Vegas, Nevada. He is an associate professor of neurology at the University of Nevada School of Medicine.

Have a question? University Health System doctors answer select questions from readers like you.