Do I really have Alzheimer’s disease?

Alzheimer’s disease is very common. But before making that diagnosis, it is very important to rule out other causes of thinking and memory problems. This is very important because there is no 100% accurate test for Alzheimer’s disease.

Let me tell you first about 3 common diseases whose diagnosis is often missed!

1. Depression:

When patients are depressed, they frequently keep ruminating about the things that they are depressed about. They are not able to focus on anything. A person’s depression may not be obvious. Some people do not express their feelings. They may suffer from severe depression, but they maintain a stoic expression. It’s better to talk about depression than to hide it. There are many effective treatments, including counseling and medications, which can dramatically improve your symptoms.

2. Obstructive Sleep Apnea:

This is a very important disease to know. If you snore heavily at night, if your bed partner has noticed that you sometimes stop breathing at night, or if you feel sleepy during the day, you may have obstructive sleep apnea.
In this disease, your windpipe closes while you are sleeping. This causes the blood oxygen level to drop. Your brain does not get adequate oxygen, and this causes problems in thinking and memory. This disease also increases the risk of heart attacks and lung disease.

Obstructive sleep apnea is often missed for many years before being diagnosed.

Obstructive sleep apnea is diagnosed by having you sleep while being monitored by instruments that measure your breathing and blood oxygen level. This is called a “sleep study”.
This is a serious disease, but we have very effective treatments. Many people may get rid of this problem through weight loss and exercise. People with severe problems may need a small machine that keeps your windpipe open while you are sleeping.

3. Side-effects of medication:

Some medications can cause problems with thinking and memory, particularly in the elderly. If you are taking any of these medications, do not stop taking them abruptly. You should talk to your doctor about your problems. Your doctor may recommend you to reduce the dose, gradually switch you over to another medication; or he/she may advise you to continue the medication because there is no other alternative.

Next, let me tell you about 3 very common diseases whose diagnosis is not often missed, since most people know about them:

1. Deficiency of Vitamin B12:

Vitamin B12 is found in meat, fish, milk and eggs. It is also present in green leafy vegetables, but in a much smaller quantity. If you are exclusively vegetarian, you may develop B12 deficiency. An important symptom of B12 deficiency is unsteadiness while walking, especially in the dark.
The B12 level in your body can be easily measured by a simple blood test.

Vegetarians are more likely to get B12 deficiency.

Patients with B12 deficiency can be easily treated with oral B12 tablets in most cases.
Deficiency of a related vitamin called folic acid may also cause dementia. Folic acid is found in green leafy vegetables and beans/lentils (rajma, dal, masoor etc).

2. Hypothyroidism:

The thyroid gland is a small gland in your neck. If this gland is not producing enough thyroid hormone, you can have problem with your memory. Other symptoms of hypothyroidism include weight gain, feeling very cold all the time, and chronic constipation.
Hypothyroidism can be easily diagnosed by a blood test and easily treated with oral thyroid hormone tablets.

3. Infection:

Certain infections, particularly syphilis and HIV, can cause dementia. Both syphilis and HIV are spread from person-to-person by unsafe sexual contact.

Lastly, let me tell you about 4 other diseases:

1. Stroke:

If you have many small strokes in your brain, you may develop a kind of dementia called “Multi-Infarct dementia”. Usually, this kind of dementia is caused by uncontrolled diabetes, cholesterol and high blood pressure.

2. Accumulation of heavy metals:

Sometimes, accumulation of heavy metals can lead to dementia. Lead and other heavy metals can be detected through a simple blood test. Treatments to remove these metals from the body are available.

3. Structural problems of the brain:

Sometimes, structural problems can cause dementia. For example, “Normal Pressure Hydrocephalus” is a dementia that is caused by accumulation of too much water in the brain. It can be treated very effectively. A small surgery is required, and a small tube going from the head to the abdomen is placed under the skin. This tube drains the excess fluid around the brain into the abdomen.

Normal Pressure Hydrocephalus (NPH) responds beautifully to shunting.

4. Autoimmune Encephalitis:

This a relatively newly discovered disease. It is very important to look for this disease, especially if the dementia is rapidly progressive since this disease can be treated almost completely.