Alzheimer's Disease

Alzheimer’s disease is the most common cause of dementia. It isn’t a normal part of the aging process — it’s a brain disorder that is slowly progressive. Over time, its symptoms may get worse and affect your memory, thinking, learning and word-finding ability.

What to expect at your first appointment

Finding out if your symptoms are signs of Alzheimer’s is the first step. It’s normal to have lapses in memory or trouble concentrating at times — like remembering why you walked into a room. Alzheimer’s disease goes beyond these typical lapses. Alzheimer’s changes how your brain makes and stores new information (memories). It also impacts other aspects of cognitive function.

At your first appointment, our specialists will take a detailed history from you and your family members or close friends who accompany you. We will also assess your memory and other aspects of cognitive function — such as problem-solving ability, focus, counting and language skills — and perform a neurological physical examination.

We encourage you to bring a family member, spouse or close friend with you to this appointment and all of your follow-up visits. It’s often helpful to have someone you trust with you to listen, take notes, answer questions and give their perspective of your condition.

Other tests

We may also do more in-depth testing, such as:

• Blood tests. We use blood tests to rule out other conditions.
• Neuropsychological testing. This is a more involved cognitive test and takes longer to complete. It dives deeper into your memory and attention skills, as well as your personality, planning, reasoning and language skills.
• Brain MRI. This scan can show if there are changes (atrophy) in your brain tissue. A brain MRI can also help us rule out other conditions, like strokes, tumours, fluid buildup in your brain or other damage that can cause Alzheimer’s-like symptoms.
• PET scan. Specialised PET scans can identify excess amyloid protein buildup in your brain — the key hallmark of Alzheimer’s disease.
• Lumbar puncture (spinal tap). With this procedure, we take a small sample of cerebrospinal fluid from your spine, under local anaesthetic, to check the levels of abnormal amyloid and tau proteins in your brain./li>

At present, it is not possible to completely stop the progression of Alzheimer’s disease or reverse it. But it is possible to partially improve memory, concentration and other aspects of cognitive function with medication. This will elevate the quality of life for you and your loved ones. Medications are typically the first step in managing Alzheimer’s-related symptoms. New medications to slow the progression of Alzheimer’s disease are also now available. Your consultant may recommend:

• Cholinesterase inhibitors like donepezil (Aricept^®), rivastigmine (Exelon^®) and galantamine (Reminyl^®).
• NMDA antagonists (receptor blockers) like memantine (Ebixa^®).
• New medications, including anti-amyloid therapies like lecanemab (Leqembi^®) that slow Alzheimer’s progression (not just treat its symptoms), have recently been licenced by the Medicines and Healthcare Products Regulatory Agency (MHRA) and are now available at Cleveland Clinic London.

Your neurologist will help you and your family gain a deeper understanding of the condition and the way in which it may develop and affect you over time. They will also:

• Guide you to reliable sources of written information and support, including patient support groups and community nurse specialists
• Discuss your care needs and how to achieve these
• Refer you to physiotherapists, occupational therapists, speech therapists or neuropsychologists where needed
• Help with psychological support, including discussing treatment options for anxiety or low mood which may coexist with Alzheimer’s disease
• Liaise closely with your GP about diagnosis, treatment and your care needs
• Advise you about driving and the DVLA regulations
• Advise you about important issues such as Lasting Power of Attorney
• Discuss genetic testing where appropriate
• Advise you about research developments and how to learn more about participating in clinical trials and research related to Alzheimer’s disease

Second opinions

If you’ve already been diagnosed with Alzheimer’s disease, you can turn to our experts for a second opinion. Our experienced neurology consultants will go over your diagnosis with you, answer questions and help you think about what comes next. Second opinions can give you confidence and peace of mind about your care moving forward.

What’s Next?

We know you face many challenges if you or a loved one has been diagnosed with Alzheimer’s disease. It’s not an easy road, but it’s one that we may be able to help you manage. Our expert neurology consultants are here with the latest treatments and compassionate support.