diagnosing dementia - Alzheimer's Disease & Dementia Message Board

gothope · 03-18-2006, 01:36 PM

I'm new here. Hope I can articulate what I am looking for.

How is Alzheimers diagnosed? Is incontinence a symptom?

My SIL has a dementia but the doctors have not been able to find the cause. Seems like one (ie the doctors) would want to find the cause in order to treat the dementia. She has had 2 MRIs and blood work; also LP for spinal fluid. At first they said stroke, but now they say not.

She is 65. She has had dementia (slowly getting worse) for 3-4 yrs. No diagnosis except dementia. Is it normal to not be able to give a definitive diagnosis? Guess I am not sure what I am asking. Just frustrated. Thanks for listening.

Sandyspen · 03-18-2006, 03:25 PM

Hi Gothope,

Welcome! I'm sorry that your SIL has this awful disease. It is so frustrating to watch in those we love.

I think it's pretty common to NOT be able to diagnosis what caused the dementia. Many things can cause it; stroke, alzheimers, etc.

My Mom's began many years ago, slowly. When we finally got a diagnosis last year, they weren't for certain what had caused it. I believe they have fairly standard treatments for every one, regardless of the cause. Unless, of course, it's misdiagnosed and not dementia at all but another illness.

Incontinence is a symptom, later into the disease. On the opening page to the Alzheimers board, there is a sticky that lists the symptoms. The Seven Stages. You might be interested to read it, also.

I'm sure some of the other ladies will be along shortly, and may have more answers for you.

I'm glad you found us.

BarbaraH · 03-18-2006, 03:59 PM

Hi Gothope,

Another welcome to you! Sorry you need to ask these questions - we do understand.

My mother was in her early 80s when 1st diagnosed with dementia by her long-time doctor. He just announced that was what was wrong because of the odd things she'd done that I could tell him about - forgot math and how to write a check, house became very cluttered, had several car accidents, couldn't tell what mail was important and what was junk, etc. As her memory problems worsened and were more apparent (I lived far from her), I found the 7 Stages of Alzheimer's during my on-line search. I was dismayed to find how many of her odd behaviors were listed as part of the early to mid stages of Alzheimers. I travelled back to see her and I took her back to the doctor with my printed 7 Stages list on which I'd highlighted all of the things Mom was doing or saying. The doctor looked at that and said, "I suppose she does probably have Alzheimer's and not just dementia." No tests, nothing. He just went by the evidence that I presented. Probably almost 2 years went by before Mom became incontinent and she'd long forgotten I was her daughter by then.

At best, an Alzheimer's diagnosis is what you're left with after lots of tests show no other cause for the memory loss and decline in abilities. Sometimes in the late stages of Alzheimer's an MRI can pick up some oddities in the brain.

If your SIL is suddenly incontinent, she may have a urinary tract infection, so suggest to her doctor or her family that be checked.

Come back anytime. We pop in frequently.

Wishing you well - Barbara

gothope · 03-18-2006, 03:59 PM

Thank you, Sandy. I read the seven stages and it helped me a GREAT deal. It made me think that perhaps my brother is in denial about his wife's "problem". I am confused, probably because my brother is confused. I live away, in a different state.

After reading the seven stages, I began to think: my SIL's behavior started changing YEARS ago. First, she lost her job. A yr or two later, my brother reported rather matter of fact that she could not remember gadgets on their new car. It was then I asked him to get her tested by doctors. He did in time. In past yr, she has had all the tests. Now, she is incontient, quiet (VERY unusual for her), not oriented to time. I think she is quiet in order to hide how little she remembers. She does not wander, she is socially appropriate, she cannot do any household chores - totally dependent on her husband.

My brother says AD and other causes of dementia (stroke, vascular, etc) have been ruled out. I am beginning to think that her dementia is AD, and that we are all dealing with denial.

I think from reading your reply that it does not matter what kind of dementia she has - she has dementia. I guess our goal should be caring for her and coping ourselves. It is hard to face until one experiences it. You just keep hoping that the cause can be found and that the dementia reversed. It is very sad. Thanks again. I am so thankful I came here and read those seven stages.

gothope · 03-18-2006, 05:18 PM

That's an excellent idea, Barbara, about UTI. I should have thought of that.

My SIL is only 65 and best I can tell the deterioration started at age 60.

The MRIs and other tests do show Brain shrinkage and moderate enlarged ventricles. AD does not have these problems, right? Or could you have the ENLARGED VENTRICLES with AD. I think I remember that brain does shrink with AD. Also a test showed that she is getting good blood flow to brain. One minute I think AD, and one minute I think it is not.

I think what I am concerned about is that it is NOT AD and that it could be something that we can control - like B12 deficiency, etc. (We hope)

If anyone knows why the brain shows shrinkage AND why there is moderate enlarged ventricles, please let me know. We are getting to the end of diagnosing I believe.
Thanks to everyone....GotHope