AD Clinical Evaluation

Karl38

My wife exhibited memory loss and cognitive impairment about 3 years ago. Her PCP noticed it and did a brain scan and other tests to rule out common causes. There were none.  He told me he thought she had AD and did not recommend further testing.  I asked for a referral to a neurologist who did more blood work and spent about an hour with her in the office.  The diagnosis was "probably Alzheimer's".  The neurologist did not recommend any further testing.

I know there is more testing that can be done such as PET scans and MRIs.  But it looks like I will have to push to get any more testing done.  Is it really worth it?  My wife hates the testing and does not want to do any more. 

Any advice is appreciated.

Stuck in the middle

If the doctor has ruled out treatable illness, I see no benefit from further testing.  Insurance will not cover PET scans etc. when no change in treatment will result from the test, and you would be spending thousands of dollars you will need for her care and for yourself. 

I'm sorry you are facing this, but "probable Alzheimer's" is as specific as doctors can get without autopsy.  My wife had CT and MRI, and recently had a spinal tap for another reason.  The result of the spinal tap was "consistent with a high probability of AD" but still no 100% definitive diagnosis.

Unless something changes that supports a different diagnosis, I suggest you try to accept the hand you have been dealt and learn how to deal with it.

Vitruvius

My DW underwent several hours of testing at an Alzheimer’s center associated with a state teaching hospital. These tests were administered by a professor of neurology and by a neuropsychologist who both specialize in dementia. These tests included the MMSE and the MOCA. She also had had a recent CT and MRI.  Nonetheless although these test indicated possible Semantic Dementia (SD), they could not rule out AD and they recommend a PET scan as well as other lab tests. The PET scan confirmed the SD diagnosis and she was further referred to a neurologist at a national university hospital who specializes in rare FTD variants. They told me that meds used for AD would not be advised for SD and made other recommendations. Getting a specific diagnosis doesn’t change the course of the disease but it helped both with getting the right meds and at least as important it helped me understand the specific’s of DW’s symptoms. She has a Medicare supplement plan which did in fact cover the PET scan.