Advances in diagnosing Alzheimer's disease

Until recently, Alzheimer’s disease was diagnosed largely on the pattern of symptoms, cognitive testing and the exclusion of other causes. A confident diagnosis often took time, and in the earlier stages it could be difficult to distinguish Alzheimer’s disease from other causes of memory change.

That has changed. It is now possible to look directly for the biological changes associated with Alzheimer’s disease, which can support an earlier and more accurate diagnosis. Three tests are increasingly used, and Dr Tina can advise which, if any, is appropriate for you.

Blood tests

Newer blood tests can detect proteins associated with the changes that occur in the brain in Alzheimer’s disease. They are less invasive than the alternatives and require only a standard blood sample. These tests are used alongside clinical assessment rather than in place of it, and a result is always interpreted in the context of your symptoms, examination and other investigations.

Cerebrospinal fluid testing

Cerebrospinal fluid is the fluid that surrounds the brain and spinal cord. A small sample is collected through a lumbar puncture, a procedure performed under local anaesthetic, and analysed for the same protein markers. It is a well established test with a strong evidence base, and is often used where a blood test result is unclear or where a more definitive answer is needed.
Amyloid PET is a specialised brain scan that shows whether amyloid protein has built up in the brain. It gives a direct picture of one of the hallmark changes of Alzheimer’s disease. Availability is limited and the scan is not currently subsidised, so it is reserved for situations where the result will meaningfully change management.

What this means for you

Not everyone with memory concerns needs these tests. Dr Tina will take a history, examine you, review your cognitive testing and arrange standard investigations first. Where a biomarker test would add useful information, she will discuss the options with you, including what a result would and would not tell you.

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