DIAGNOSING ALZHEIMER'S DISEASE

An Accurate Diagnosis Depends on More Than Any Single Test

Dr. Peters considers symptoms, cognitive function, medical history, brain imaging, laboratory results, and, when appropriate, Alzheimer’s biomarkers to determine the most likely cause of cognitive changes.
The goal is to understand what is causing the changes and what should happen next.

How Is Alzheimer’s Disease Diagnosed?

No single test can diagnose Alzheimer’s disease by itself. Dr. Peters considers the full clinical picture, including symptoms, cognitive function, medical history, brain imaging, laboratory results, and, when appropriate, Alzheimer’s biomarkers.

Step 1: Understanding What Has Changed

The evaluation starts with a conversation about the changes you or those close to you have noticed, when they began, and whether they have worsened over time. Dr. Peters also considers how those changes affect everyday activities.
A spouse, family member, or care partner can provide useful perspective, especially when changes are easier for others to notice than for the patient.
Dr. Peters also reviews your medical history, family history, and medications.

Step 2: Assessing Memory and Thinking

Dr. Peters performs a neurologic examination and a structured cognitive assessment to evaluate memory and other areas of thinking.
These assessments provide important information, but no single score tells the whole story.

Step 3: Looking for Other Possible Causes

Routine laboratory tests can help identify medical conditions that may cause or contribute to cognitive symptoms.
These tests are different from Alzheimer’s blood biomarkers. Routine laboratory testing looks for other possible explanations for cognitive change, while Alzheimer’s biomarkers look for biological evidence associated with Alzheimer’s disease.

Step 4: Looking at the Brain

A brain MRI provides detailed images of brain structure. It can help identify other conditions that may contribute to cognitive symptoms and provide additional information that helps clarify the diagnosis.

Step 5: Looking for Evidence of Alzheimer’s Disease

When appropriate, biomarker tests can look for biological changes associated with Alzheimer’s disease. Depending on the situation, this may include blood-based biomarkers, amyloid PET imaging, cerebrospinal fluid testing, or other specialized testing.
Biomarker results are considered together with the rest of the evaluation to help determine whether Alzheimer’s disease is the likely cause of mild cognitive impairment or dementia.

Biomarkers Can Help Identify Alzheimer’s Biology

Alzheimer’s disease causes specific changes in the brain, including the buildup of amyloid and changes in a protein called tau. Biomarkers are tests that can look for evidence of these changes while a person is alive.
Depending on the situation, biomarker testing may include amyloid PET imaging, tests of cerebrospinal fluid, or blood-based biomarkers. These tests do not replace the rest of the evaluation. Instead, they add another piece of information that Dr. Peters can consider along with symptoms, cognitive testing, medical history, and brain imaging.
Biomarkers can help show whether Alzheimer’s disease is likely to be contributing to a person’s cognitive changes. They are especially important when newer anti-amyloid treatments are being considered, because those treatments require evidence that amyloid is present in the brain.
No biomarker result stands alone. Dr. Peters considers biomarker findings together with the patient’s symptoms, cognitive assessment, medical evaluation, and brain imaging to determine the most likely diagnosis.

What Happens After the Evaluation?

Once the evaluation is complete, Dr. Peters reviews the findings with you and your care partner and explains what they mean. The next step depends on what the evaluation shows.

Possible outcomes may include:

• No significant cognitive impairment
• Mild cognitive impairment that is not likely caused by Alzheimer’s disease
• Mild cognitive impairment due to Alzheimer’s disease
• Dementia caused primarily by another condition
• Dementia due to Alzheimer’s disease
• More than one condition contributing to cognitive decline
• A need for additional evaluation or follow-up before a diagnosis can be made
If Alzheimer’s disease is identified, Dr. Peters considers the stage of disease, medical history, test results, and other clinical and safety factors to determine which treatment options may be appropriate. A diagnosis of Alzheimer’s disease does not automatically mean that anti-amyloid treatment is appropriate.
If disease-modifying treatment may be appropriate, the next step is to understand the potential benefits, risks, requirements, and alternatives before deciding whether to proceed.

Explore Alzheimer's Treament Options

Concerned About Memory or Cognitive Changes?

If you or someone close to you has experienced persistent or progressive changes in memory, thinking, or everyday function, a neurologic evaluation can help determine what may be causing them and what steps should come next.

Schedule an Evaluation

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