spots on the brain and an alzheimer diagnosis

my 60 yr old sister just received a diagnosis of probable alzheimers.  I am uncomfortable with this information/diagnosis and believe it is premature.  I am not EXACTLY sure these were the words used by the Dr, or just what her mind heard.  The Dr did a brain scan (not sure which type) and found spots on her brain.  He stated these spots may be due to small strokes which she suffered -at some time in her life- and intends to do additional testing(in attempt to determine the cause of the spots).  She has demonstrated  small levels of forgetfulness through the years, slightly increasing, but not to the point that it is affecting her functionality. She has ALWAYS been a bit 'scatter-brained' and she and her husband feel it has gotten worse.  The rest of the family, who do not see her regularily, have noticed a slight change when she is stressed only. Our father passed away 3 years ago from cancer (at 80) and had been diagnosed with Alzheimers 4 years earlier. His symptoms were obvious but he was still living at home with assistance from his wife. I am concerned that my sister, is using Dad's diagnosis as a fatalistic prognosis without waiting for a full/complete work up.  What can be told by brain spots?  What additional testing should we expect to see?  What reading is available for me to research Alzheimer diagnostics? She has not told the whole family 'until she gets the rest of the testing done', which I agree with.  I just wish she would wait for the tests too.  She believes she has alzheimers and consequently is very depressed.  I would like to help her open her mind to possible alternate diagnosis-at least until a more conclusive diagnosis can be made and other causes eliminated.

[rumpled]

I am sorry to hear about your sister.

I would get the spots are *white matter* and can be caused by anything from small strokes to high blood pressure.

There are many sites for dementia and Alzheimer - that can simple be looked for using your favorite search engine. It can be subtle to some especially if the person has a long progression of the disease? Also they list several stages and from the people I have known, the stages are fluid - people do not progress through them in order all the time. I know my MIL did not and now my FIL is not following the order either.

I do believe the diagnosis is one of exclusion - so you rule out everything else and it leaves just that. It sounds like at this time your sister is in the process and the diagnosis is not final.

From a dementia site - how to diagnose:
    "A thorough medical history
    Mental status testing
    A physical and neurological exam
    Tests (such as blood tests and brain imaging) to rule out other causes of dementia-like symptoms "

I hope your sister gets other news.

[strangecindy]

thanks so much for your kind words.  I will keep my fingers crossed

[Nikodicreta]

Hey strangecindy.

Unfortunately, a negative belief/emotion and the stress associated with this, such as in your sister's case, may indeed be a co-factor in her cognitive decline and memory issues.

Probable Alzheimer's is, to my opinion, a disservice to the patients, as a significant aspect of a diagnosis, is diagnosis of exclusion of other conditions presenting similar symptomology.
It is , again to my opinion, a way out  for the diagnosing physician,
in the event that it turns out to be something else.

You may be on to something here, with your suspicion.
The static imaging of spots on the brain from an MRI, is hardly indicative of anything relative to Alzheimer's at all!

The final diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has been approved by the American Psychiatric Association (APA) as of Dec. 5th, but won't be published till sometime in May of 2013.

You may message me directly for a link for a website  that comprises a complete set of DSM-IV criteria for all currently used mental disorders.
It is the only one that has a complete set of dx criteria.

It is against MedHelp forum rules to post links for other websites and forums, blogs, etc.

Cheers!
Niko

[rumpled]

You can also PM the links! Also links can be added to a "health pages" feature if the CL asks for one to be added to the page. There isn't one here.

I agree the white spots are not relative - I help out on the brain tumor board so I get questions relative to the white matter spots frequently. They can come from so many sources.

[Nikodicreta]

rumpled, thanks  for informing me on such features.

I know that I could PM the links, however, I like to engage the newer
members and have them PM me instead, as I believe it could potentially  empower them, by giving them the opportunity to take the initiative, whenever possible.

Wow, sometimes trying to express a concept with words, just kills it! lol!
But, nonetheless, you understand what I mean.

Cheers!
Niko