Having memory loss or cognitive impairment does not necessarily mean that you have Alzheimer's disease (AD), which accounts for 50-60% of all causes. In fact, 80% of the causes of Alzheimer's disease and related disorders (ADRD) are treatable conditions, including AD. Other treatable causes of ADRD include depression, medication effects, stroke, thyroid problems, vitamin deficiencies, uncontrolled medical conditions and head injury. Finding the right diagnosis to get the right treatment as early as possible is the key to the best treatment outcome.

Applying the standardized criteria established by the National Institute for Neurological Disorders (NINDS-ADRDA criteria), AD diagnosis is 90-95% accurate. Below summarizes steps to get the right diagnosis.

1. Find the Right Physician
   For evaluating and treating ADRD, there is no substitute for experience and proper training. Neurologists, psychiatrists, or geriatricians are the specialists most likely to have been trained to evaluate ADRD using the NINDS-ADRDA criteria, as well as effectively treat the cause. Some internists or primary care physicians have also been properly trained.

2. Collecting Patient and Family History
   The medical and family histories are keys to proper ADRD diagnosis. A proper history includes:
   • The Patient or family's primary concern(s), including:
     • What were the very first symptoms?
     • When did the first symptoms start?
     • When was everything completely normal?
     • How rapidly did the first symptoms appear?
     • Did anything seem to cause these symptoms to appear?
     • How rapidly has the overall condition progressed?
   • All medications, including over the counter medications, plus when they were started.
   • List of all past and current medical conditions.
   • Life Style history including head injuries, alcohol, smoking, exercise, diet, hobbies.
   • Psychosocial history such as marital state, living conditions.
   • Family history of memory/cognitive impairment, senility/dementia, AD, ADRD and risk factors for ADRD.

3. Identify Treatable Medical Conditions
   Treatable medical conditions that can cause cognitive impairment or dementia include diseases of virtually every organ and tissue of the body, especially the heart, lung, thyroid, kidney, liver gut, blood vessels and immune system. Psychiatric or neurologic conditions, such as depression, manic-depression, anxiety and stress can also affect memory and other cognitive abilities. These conditions are identified through history and physical examination, plus diagnostic tests of blood, urine, X-rays, and brain imaging. Direct testing of mental abilities may be done to confirm cognitive impairment as well as to help diagnose its cause.

4. Brain Imaging Studies
   Brain imaging has two primary functions. First, it helps establish how much brain damage has occurred. Second, it helps diagnose the underlying cause of the damage. The choice of which brain image to do (CT, MRI, SPECT, PET or fMRI) depends upon the duration and severity of the condition. When MRI or CT scans show no brain tissue loss, imaging of the brain's activity should be done with SPECT, PET or fMRI to detect abnormalities and diagnose early.

5. Final Diagnosis
   Based on the history, examination, laboratory and brain imaging results, a properly trained physician can diagnose the cause of your condition with 90-95% accuracy using NINDS-ADRDA criteria. Typically it takes a few weeks to complete the diagnostic evaluation.