Advancing diagnosis of Alzheimer's: Two ways doctors can test for early Alzheimer’s signs

About 6 million Americans over 65 have Alzheimer's disease, the most common type of dementia. Its symptoms can make it hard for a person to live on their own and have a good quality of life, but right now there is no cure for Alzheimer’s disease.   As a result, a lot of research is focused on treatments that can help spot and slow down symptoms before they become unmanageable for those with the disease, in addition to finding a cure for Alzheimer’s. Kaiyu Ma, MD, PhD, a neurologist at Crystal Run Healthcare, believes that early testing and treatment are key to managing Alzheimer’s symptoms early. 

“Early detection of dementia and Alzheimer's can lead to better management of symptoms and a more effective use of available treatments, which can slow the progression of the disease,” said Dr. Ma.  

There are several methods and tools that doctors can use to diagnose Alzheimer’s, including medical history, physical and neurological exams and mental status tests. Your doctor will usually ask for one or more tests, along with cognitive tests, to find out if you have Alzheimer's. Additionally, there are also physical scans and tests that doctors can use to check for early signs of Alzheimer’s. These are brain scans and testing the fluid around the spine. These tests provide biomarkers (biological signs of a disease) for clinicians to check the health of a patient’s brain.   

Brain imaging/neuroimaging 
Brain imaging, or neuroimaging, is often used for early diagnosis of Alzheimer's disease. A doctor can use different types of brain imaging to see the shape, position, or size of brain tissue. They can also measure how well the cells use sugar and oxygen or find changes in the cells or chemicals in the brain. These types of tests can be done through neuroimaging tests like magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) or functional MRI (fMRI).

Cerebrospinal fluid (CSF) tests  
Cerebrospinal fluid is exactly what it sounds like — fluid around your brain and spine. It acts as a cushion and is also where your brain deposits extra proteins. With Alzheimer's disease, your brain may make too many harmful proteins. These proteins can stop your brain from working well by making plaque-like substances or tangles around your nerves. CSF testing at Crystal Run Healthcare involves a doctor performing an outpatient procedure called a lumbar puncture, or a spinal tap. Before the test, a clinician will apply local numbing to your lower back, where they will perform the lumbar puncture. A long needle is inserted between the vertebrae bones of your spine to collect a small sample CSF. The sample of CSF is then used to test for protein levels that can indicate Alzheimer’s.

There are other ways to test for Alzheimer's biomarkers that may not be covered by insurance or FDA approved, such as genetic testing and blood tests. In a recent 2024 study, a blood test predicted a diagnosis of Alzheimer’s disease with 88% to 92% accuracy. While more testing needs to be done for more data, this particular study has been the result of years of clinical testing and trials. In the future, blood testing could be a helpful choice for patients who do not have access to advanced specialty testing or radiology centers. Blood tests can instead be performed by a specialist, like a neurologist, who can use the results as part of their diagnostic process.  

"Neurologists can help play a crucial role in early diagnosis and supportive care for Alzheimer’s disease,” said Dr. Ma. “We help patients and families understand the changes occurring in the brain and plan for future care needs, all while managing cognitive and behavioral changes through comprehensive treatment plans."

The neurologists at Crystal Run Healthcare are expertly trained to investigate, diagnose and treat neurological disorders, which include diseases of the brain, spinal cord, nerves and muscles. Our experienced neurologists treat a full range of neurological disorders, including Alzheimer's disease. We can diagnose a range of neurologic conditions using state-of-the-art diagnostic equipment and technology to complete testing like MRI, CT and PET, lumbar punctures (spinal taps) and more.

Kaiyu Ma, MD, PhD, is a board-certified neurologist and sleep specialist. She earned her Medical Degree at Harbin Medical University in Harbin, China. She completed her Internal Medicine Internship at Jersey Shore University Medical Center in Neptune, NJ and her Neurology Residency at North Shore University Hospital in Manhasset, NY. Her clinical interests include neuromuscular disease (neuropathy, myasthenia gravis, muscle disease, pinch nerve, numbness, weakness) Epilepsy/seizure, neuro electrodiagnostic testing (EMG, EEG, evoked potential testing, Sleep study testing), neuro ophthalmology, headaches, stroke, multiple sclerosis, memory loss, dementia and attention disorder. Dr. Ma is currently seeing patients in Monroe and West Nyack, NY.