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Misdiagnosis of Alzheimer's Disease

Misdiagnosis of Alzheimer's Disease

A diagnosis of Alzheimer's disease may be delayed or missed because early symptoms develop gradually and are often associated with the normal aging process. In addition, symptoms of Alzheimer's disease can mimic symptoms of a variety of diseases, disorders or conditions. These include TIA, depression, vascular dementia, Creutzfeldt-Jacob disease, bovine spongiform encephalopathy, brain tumor, hydrocephalus, or advanced syphilis or AIDS....more about Alzheimer's Disease »

Alzheimer's Disease misdiagnosis: Because AD is so well-known, it is sometimes an over-diagnosed condition. Other causes of dementia or memory loss symptoms may be overlooked. Other possible diagnoses include normal aging (if very mild symptoms), emotional problems (such as grief), fatigue, depression, and certain physical medical conditions such as thyroid disease, brain tumors, multi-infarct disease, or Huntington's disease. In its early stages, a correct diagnosis of AD can also be overlooked itself and misdiagnosed as other conditions such as depression, dementia, simple forgetfulness, or senility....more about Alzheimer's Disease »

Alternative diagnoses list for Alzheimer's Disease:

For a diagnosis of Alzheimer's Disease, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Alzheimer's Disease:

Diseases for which Alzheimer's Disease may be an alternative diagnosis

The other diseases for which Alzheimer's Disease is listed as a possible alternative diagnosis in their lists include:

Rare Types of Alzheimer's Disease:

Alzheimer's Disease: Medical Mistakes

Related medical mistakes may include:

Alzheimer's Disease: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Discussion of diagnosis/misdiagnosis of Alzheimer's Disease:

NINDS Alzheimer's Disease Information Page: NINDS (Excerpt)

The early symptoms of AD, which include forgetfulness and loss of concentration, can be missed easily because they resemble natural signs of aging. Similar symptoms can also result from fatigue, grief, depression, illness, vision or hearing loss, the use of alcohol or certain medications, or simply the burden of too many details to remember at once. (Source: excerpt from NINDS Alzheimer's Disease Information Page: NINDS)

Aging -- Women Getting Older: NWHIC (Excerpt)

It is natural to lose some mental acuity as you age. Think of your brain as a computer, with megabytes of information added each year, year after year. Unlike a computer, however, we canít delete useless information. So our minds can at times experience something that feels like overload, and itís easy to forget some of lifeís details. Serious memory loss, however, is more rare. (Source: excerpt from Aging -- Women Getting Older: NWHIC)

Alzheimer's Disease: NWHIC (Excerpt)

By looking at a picture of the brain, the doctor will be able to tell if anything does not look normal. Information from the medical history and any test results help the doctor rule out other possible causes of the personís symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood vessel disease in the brain can cause AD-like symptoms. Some of these other conditions can be treated. (Source: excerpt from Alzheimer's Disease: NWHIC)

Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA (Excerpt)

Sometimes older people have emotional problems that can be mistaken for dementia. Feeling sad, lonely, worried, or bored may be more common for older people facing retirement or coping with the death of a spouse, relative, or friend. Adapting to these changes leaves some people feeling confused or forgetful. Emotional problems can be eased by supportive friends and family, or by professional help from a doctor or counselor. (Source: excerpt from Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA)

Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA (Excerpt)

Alzheimer's disease and multi-infarct dementia can exist together, making it hard for the doctor to diagnose either one specifically. Scientists once thought that multi-infarct dementia and other types of vascular dementia caused most cases of irreversible mental impairment. They now believe that most older people with irreversible dementia have Alzheimer's disease. (Source: excerpt from Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA)

Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA (Excerpt)

Stress, anxiety, or depression can make a person more forgetful. Forgetfulness caused by these emotions usually is temporary and goes away when the feelings fade. However, if these feelings last for a long period of time, getting help from a professional is important. Treatment may include counseling or medication, or a combination of both. (Source: excerpt from Forgetfulness It's Not Always What You Think -- Age Page -- Health Information: NIA)

Common Misdiagnoses and Alzheimer's Disease

Underactive thryoid may be misdiagnosed as depression: Hypothyroidism, or underactive thyroid, is an endocrine gland disorder that is more common in women. It can mimic many diseases, including depression. The patient often has depressive type symptoms, and may also have other symptoms of hypothyroidism such as tingling fingers (peripheral neuropathy), hearing loss, headaches, cold insensitivity, and many other symptms. Common misdiagnoses of hypothyroidism include depression, dementia, schizophrenia, or bipolar disorder (esp. rapid-cycling bipolar disorder).

Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer's, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30's and 40's. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

Tremor need not be Parkinson's disease: There is the tendency to believe that any tremor symptom, or shakiness, means Parkinson's disease. The reality is that there are various possibilities, such as benign essential tremor, which is mostly harmless. see the various causes of tremor and misdiagnosis of Parkinson's disease.

Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury. See the symptoms of MTBI or misdiagnosis of MTBI.

ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in children is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA). See misdiagnosis of ADHD or symptoms of ADHD.

MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury. See causes of dizziness, causes of vertigo, or misdiagnosis of MTBI.

Rare diseases misdiagnosed as Parkinson's disease: A rare genetic disorder is often misdiagnosed as Parkinson's disease for men in their 50's. The disease Fragile X disorder can show only mild symptoms in the early years, and Parkinsons-like symptoms around age 50. See misdiagnosis of Parkinson's disease.

Bipolar disorder misdiagosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist. See misdiagnosis of bipolar disorder.

Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis. See misdiagnosis of eating disorders or symptoms of eating disorders.

Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked. See misdiagnosis of depression or symptoms of depression.

Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH. See misdiagnosis of Alzheimer's disease or misdiagnosis of Parkinson's disease.

Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury. See introduction to concussion.

Children with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in children. See misdiagnosis of migraine or introduction to migraine.

Undiagnosed anxiety disorders related to depression: Patients with depression (see symptoms of depression) may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression. See misdiagnosis of depression or misdiagnosis of anxiety disorders.

Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis). See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.

Alzheimer's Disease: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Alzheimer's Disease

Failure to diagnose Alzheimer's Disease may be associated with the following:

  • Currently, diagnosis of Alzheimer's is difficult due to the lack of conclusive tests. A diagnosis of true Alzheimer's usually can only be confirmed on autopsy
  • Alzheimer's is often undiagnosed in the early stages due to inadequate testing methods. Early diagnosis allows timely treatment which can improve the prognosis

Notes On Hidden Causes Of Alzheimer's Disease

The following may be hidden causes of Alzheimer's Disease:

  • A family history of Alzheimer's disease and/or Downs syndrome increases the risk of developing Alzheimer's
  • Risk factors for Alzheimer's are age, family history of Alzheimer's and a genetic predisposition
  • Other risk factors for Alzheimer's are: serious head injury, heart and blood vessel damage due to conditions such as high blood pressure, heart disease, diabetes, high cholesterol and stroke
  • Studies also indicate that people who generally maintain a healthy lifestyle into old age are less likely to develop dementia. A healthy lifestyle involves mental and physical exercise, healthy social relationships, avoiding smoking and excessive alcohol consumption
  • Other possible risk factors includes chronic inflammatory conditions and a history of clinical depression
  • A rare genetic mutation is linked directly to the development of Familial Alzheimer's disease rather than simply being a risk factor
  • Down syndrome patients often develop Alzheimer's disease in old age

Notes On Wrong Diagnosis Of Alzheimer's Disease

Wrong diagnosis of Alzheimer's Disease may be associated with the following:

  • Diagnosis may be difficult when other neurodegenerative disorder co-exist such as Alzheimer's
  • Dementia can occur in the later stages of Parkinson's disease in up to a quarter of patients. This makes the condition almost indistinguishable from Alzheimer's and hence a wrong diagnosis can result
  • Creutzfeldt-Jakob disease is most commonly misdiagnosed as Alzheimer's disease due to the similarity of symptoms. The misdiagnosis may not be discovered until autopsy. This is a serious concern as the number of people with CJD being diagnosed with Alzheimer's is unknown but may be larger than expected. Common symptoms includes memory loss, behavioural changes and uncoordinated movements
  • Experts increasingly believe that a significant number of people suffering from advanced normal pressure hydrocephalus are being misdiagnosed as having Alzheimer's disease. Symptoms such as memory loss and movement problems are common to both disorders. This misdiagnosis is important in the fact that normal pressure hydrocephalus is usually completely treatable. Lack of treatment leads to continuing deterioration
  • Because of the difficulty in accurately diagnosing Alzheimer's disease it is important for patients to be continually monitored even after they have been diagnosed with Alzheimer's disease as the progression of symptoms may point to a misdiagnosis or may further confirm and an Alzheimer's diagnosis
  • Alzheimer's is frequently misdiagnosed as its main symptom, dementia, is common to a number of disorders, some of which are completely treatable
  • Frontotemporal dementia is another dementia disorder which has clinical symptoms so similar to Alzheimer's that even dementia experts may have difficulty distinguishing the two conditions. Alzheimer's drugs can make frontotemporal dementia symptoms worse
  • Multi-infarct dementia also has similar symptoms to Alzheimer's and may be misdiagnosed. These symptoms include confusion, memory loss, incontinence and behavioural changes. Often only a brain biopsy is able to distinguish between the two. Diagnosis may be further complicated in patients who have both conditions
  • A degenerative brain disease called Huntington's disease may be misdiagnosed as Alzheimer's but a genetic test can conclusively diagnose or eliminate Huntington's disease. Symptoms that may be common to both includes involuntary movements, personality changes, depression, memory loss and reduced ability to make decisions
  • Pick's disease may be misdiagnosed as Alzheimer's disease due to the similarity of symptoms - personality changes, confusion, memory loss, and language and movement problems. A diagnosis can only be confirmed by an autopsy.
  • Lewy Body Dementia may also be misdiagnosed as Alzheimer's with common symptoms being confusion, language problems, memory loss and eventually movement problems
  • Nutritional deficiencies which result in dementia symptoms may be misdiagnosed as Alzheimer's disease. This is particularly disconcerting as nutritional deficiencies are readily treatable. For example thiamine deficiency (Wernicke-Korsakoff syndrome), vitamin B12 and B1 deficiency (due to alcohol abuse, chemotherapy or eating disorders) may cause symptoms such as confusion and memory problems which may be mistaken for Alzheimer's
  • Thyroid problems, certain infection and certain drugs may cause dementia symptoms which can lead to a wrong diagnosis of Alzheimer's. Again, this is particularly worrisome as these conditions are readily treatable
  • Brain tumors may also produce dementia symptoms which may be wrongly diagnosed as Alzheimer's. A CT or MRI scan can differentiate between the conditions

Complications Of Misdiagnosis Of Alzheimer's Disease

The following may be complications of misdiagnosis of Alzheimer's Disease:

  • Mental impairment that occurs in the elderly is often overlooked as a symptom of Alzheimer's and is simply attributed to the normal processes of aging. This view is often held by health professionals as well as patients. They tend to ignore or dismiss the early symptoms of Alzheimer's
  • Depression in older people may be misdiagnosed as Alzheimer's disease due to common symptoms such as memory and thinking problems, personality changes and reduced attentiveness. The risk of misdiagnosis is increased by the fact that often Alzheimer's patients also have depression

Other Notes On Misdiagnosis Of Alzheimer's Disease

  • An accurate diagnosis of true Alzheimer's is vital as symptoms in Alzheimer patients due to other causes may be reversible
  • Due to the range and variation in the possible causes of Alzheimer's-like symptoms, it is important that a full medical history is done on patients in order to avoid a wrong diagnosis

Medical news summaries about misdiagnosis of Alzheimer's Disease:

The following medical news items are relevant to misdiagnosis of Alzheimer's Disease:

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Alzheimer's Disease or confirming a diagnosis of Alzheimer's Disease, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Alzheimer's Disease may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Alzheimer's Disease. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.

 

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