- Depression, cardiovascular accidents, or brain tumors can cause similar pictures.
- Why slow walking could be a symptom of Alzheimer's
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Alzheimer's is a disease that poses unique challenges to clinicians at all levels. One of them is the diagnosis since there are several conditions that can cause symptoms similar to those of Alzheimer's.
Depression, strokes, tumors...
Dr. Enrique Arrieta, a family doctor at the Segovia Rural health center, reflected on this issue within the framework of the symposium for the XXX anniversary of the Fundación Alzheimer España held at the Illustrious Official College of Physicians of Madrid this past Thursday, June 9.
In his speech, Arrieta explained that, despite the fact that in recent years there have been great advances in the discovery of biomarkers (measurable biological parameters that indicate with certainty a certain process in an organism), the first step in the diagnosis of Alzheimer's continues to be the differential diagnosis, which is a difficulty from primary care itself.
This implies carrying out a series of neurological, psychological, and physical tests to establish the set of symptoms (which he detailed in the presentation) and subsequently rule out other pathologies that may be causing them. And it is that, as Arrieta pointed out, there are several diseases that can cause similar pictures.
For example, he explained, it is necessary to verify that the patient does not suffer from diseases such as damage derived from past cardiovascular accidents, Parkinson's disease, vitamin B12 deficiency, or certain endocrinological disorders such as thyroid disorders or brain tumors.
Even in older people, there is a particularly common disease that can mimic Alzheimer's: major depressive disorder. And it is indeed, as Arrieta pointed out, in older people depression can manifest itself with signs such as memory problems, changes in life habits, slowness, coordination problems, hostility...
In fact, some of the cognitive tests used to guide the diagnosis (although they are not used in isolation) can give false positives in illiterate people.
For this reason, it is especially important that relatives and close people observe and pay attention to the symptoms that the elderly person shows, in order to guide the doctor in primary care as best as possible: "It is not about doing many tests; it is about doing the right test, choosing the one that will be most useful for each type of patient".
References
Arrieta, E. Early diagnosis of Alzheimer's disease in primary care: brief cognitive tests. Symposium XXX anniversary of the Fundación Alzheimer Spain. Madrid, 06/09/2022.
Sanchez, P; Garcia, G; Arrieta, E; and Pérez, D. Round table: "Are we facing a new era in the diagnosis of Alzheimer's disease?" Symposium XXX anniversary of the Fundación Alzheimer Spain. Madrid, 06/09/2022.
Mayo Clinic. Diagnosing Alzheimer's Disease: How Alzheimer's Disease Is Diagnosed. At https://www.mayoclinic.org/es-es/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075