Question:
My mom is convincing herself that she is experiencing the early signs ofAlzheimer's. The truth is that she was DX with clinical depression about 3years ago. She has been on numerous different antidepressants but none seemto have lifted the depression significantly. She has good days and bad days.On bad days she has a real problem forming thoughts and speaking fluently.On Good days she is better but not 'her normal self'. I notice mostly aproblem with her grabbing the right words when trying to speak but notnoticing and gaps in 'life' memory. Her DR. is looking into the prospect ofAlzheimer's, they are playing around with her meds trying to get thedepression lifted and getting her to sleep soundly at night. She lives onher own in a retirement home and has lots of friends that she is with mostall the time. She is working part time and her job seems to be going fine.I am needing more info. on the EARLY signs of Alzheimer's. I'm not convincedthis is her problem but want to make sure that I am not in denial either!Actually, the prospect of her getting Alzheimer's is very scary to me beingas she has NO savings, lives pay check to pay check (work and ssi) and myhusband and I have NO means to take care of her!Also would like some info. on tests that can either rule out Alzheimer's orconfirm it. (my mom has her medical care thru' Kaiser and they seem to dragtheir feet on giving tests that are expensive. Their way to find the problemis thru' musical meds at this point. I think my moms state of mind would bebetter if Kaiser would just get down to the point, you know what I mean?)

Any comments for me???

Answer: That's a clue that the root of the problem may not be depression. That doesn'tnecessarily mean it's alzheimers.

The absence of your typical memory problems would be a strike againstAlzheimer's. Speach disorders can be manifest in AD but can also be present inother things--like primary progressive aphasia. You don't say how old she isbut word finding problems start becoming evident when we hit our thirties andit's all down hill from there. So, the question becomes, are your mom's wordfinding problems worse for her age normed cohort. Some simple testing willanswer that question.

Early signs of AD, are evidenced in subtle memory lapses otherwise known as mildcognitive impairment. We are just starting to get reliable data on MCI--a coupleof good logitudinal studies are going on. So far, it looks like about 70%(IIRC) of those identified as having MCI will go on to be diagnosed with AD.MCI is assessed by standard neuropsychological measures.

There's no good medical tests at this point. You can have genetic testing forthe appo-e lipoprotein gene marker but this is neither particularly sensitivenor specific. Imaging studies can be useful in more advanced cases but prettymuch useless in mild cases. If she has a focal problem in the left temporallobe (assuming she's right handed) from either a mild stroke or TIA, that couldbe evident on scans and that would also pretty much "rule out" AD. Well, maybenot completely rule it out but it would provide an alternative hypothesis forher symptoms.

The "gold standard" for diagnostic assessment is neuropsychological testing. Itprobably costs as much as the apo-e testing but it results in a comprehensiveassessment of the person's strengths and weaknesses, it is highly predictive ofthe AD diagnosis and can also be useful in identifying what else might be goingon with the person.