Alzheimer's Disease Diagnosis and Treatment

Dr. Jeffrey Kaye visiting with a patient in clinic
Dr. Jeffrey Kaye is the director of the Layton Aging and Alzheimer’s Center. He is known internationally for his expertise and research on aging, and on Alzheimer’s and other dementias.

At OHSU, our specialists offer the most effective ways to diagnose and treat Alzheimer’s disease. We offer: 

  • Leading-edge tests and brain imaging for an accurate diagnosis. 
  • Tailored care from experts with advanced training in aging issues, and in Alzheimer’s and other dementias. 
  • Clinical trials to test new ways to manage symptoms, extend independent living and support quality of life.

When should I see a provider?

Anyone who has ongoing or worsening memory loss or other signs of dementia should see a health care professional for a full exam. 

Visit our Understanding Alzheimer’s Disease page to learn more about:  

  • Alzheimer’s symptoms 
  • Warning signs  
  • When to get checked 

Your visit to OHSU

You will receive a medical-history form in the mail. Please fill it out. Ask a family member or friend to help. Please call us at 503-494-7772 with questions. 

Please bring to your appointment: 

  • Your completed form 
  • A list of medications you take 
  • A list of any vitamins or supplements you take 
  • A family member to help provide information and to help us plan your care 

The visit will take about two hours. Your provider will: 

  • Review your medical history with you and your family member 
  • Do a brief physical exam 
  • Do a neurological exam to check brain and nerve function 
  • Go over any records from your referring provider 

Diagnosing Alzheimer’s disease

No single test can confirm Alzheimer’s disease. At OHSU’s Layton Aging and Alzheimer’s Disease Center, our neurologists review your symptoms and test results. This evaluation can identify Alzheimer’s disease and rule out other possible causes.  

How is Alzheimer’s disease diagnosed?

Tests may include: 

Physical exam and medical history: We assess your overall health with a physical exam and discuss your medical history. It’s a good idea to bring a family member with you. This person can help remember details, especially if you’re having memory trouble.  

Your medical history includes: 

  • Symptoms  
  • Previous and current illnesses or conditions 
  • Medications you’re taking 
  • Family medical history, including relatives with Alzheimer’s or other dementias
Allison Lindauer with a patient. Patient is drawing on a clipboard that Lindauer is holding.

Neurological exam: We look for signs of Alzheimer’s and other possible brain disorders. We test your: 

  • Reflexes 
  • Muscle tone and strength 
  • Senses, including sight, touch (sensation) and hearing 
  • Coordination and balance 

Mental status tests: Your doctor will ask you some simple questions for about 10 to 20 minutes. These tests can detect problems with thinking and memory such as: 

  • Attention and concentration 
  • Memory, including short-term memory and working memory (remembering information for immediate use) 
  • Orientation, including the awareness of self, time and place 
  • Language, including comprehension, naming and repetition 
  • Constructional ability, such as drawing from memory 
  • Calculation skills 
  • Executive skills, such as judgment 
Hand drawing a clock face on a piece of paper on a clipboard
You might be asked to do simple tests such as drawing a clock.

Mood assessment: We ask questions to check for signs of depression, anxiety or other disorders. These conditions can affect memory. They can also cause symptoms similar to those of Alzheimer’s.  

Brain imaging: We may order scans to check for or rule out other conditions such as a brain tumor, stroke or head injury. At OHSU, our brain imaging technologies include: 

  • Computerized tomography: CT scans use special X-ray equipment to produce cross-sectional images of the brain. 
  • Magnetic resonance imaging: MRI scans use radio waves and a powerful magnet to create detailed images. They help rule out other conditions or check for brain shrinkage. 
  • Positron emission tomography: PET scans involve an injection of a small amount of a radioactive substance and a special camera. A PET scan shows blood flow and other activity in the brain. In some cases, we can use advanced PET technology to see the buildup of a brain protein that may be an early sign of Alzheimer’s.  

Blood tests: We can often rule out other causes by measuring how your thyroid gland is working and whether you lack certain vitamins. 

Spinal tap (lumbar puncture): We may collect a small sample of brain and spinal cord fluid. This test helps us rule out infections that can cause similar symptoms.  

Genetic testing: Researchers have found some inherited DNA changes related to Alzheimer’s disease. Routine testing is not recommended. If you or a loved one has early-onset Alzheimer’s or a strong family history of it, a genetic counselor can help you understand options. Learn more on our Understanding Alzheimer’s Disease page.

Alzheimer’s disease treatments

Our team of neurologists and nurses specialize in Alzheimer’s disease and other types of dementia, and in aging issues (geriatrics). We meet as a group each week to review patient cases. Together, we discuss treatment plans to support patients and their families.  

Current treatments aim to: 

  • Slow symptoms 
  • Help you maintain mental function  
  • Stay independent longer 

Treatments can control symptoms only for a while, though. The length of time varies from person to person. There is no cure for Alzheimer’s, and treatments cannot stop it from getting worse.

Medication for Alzheimer’s disease

As it progresses, Alzheimer’s damages and destroys brain cells called neurons. These cells are the brain’s messengers. Medications can’t stop the damage, but they can slow some symptoms by improving communication among neurons.  

Mild to moderate Alzheimer’s disease: Medications called cholinesterase inhibitors can control symptoms related to thinking and behavior. These medications provide acetylcholine, a chemical messenger (neurotransmitter) that becomes depleted as Alzheimer’s progresses. They include: 

  • Donepezil (Aricept) 
  • Rivastigmine (Exelon) 
  • Galantamine (Razadyne) 

Moderate to severe Alzheimer’s disease: A drug called memantine (Namenda) supports brain functions such as memory, attention and language in later stages of Alzheimer's. It also can make it easier to do daily activities. 

Other medications approved by the U.S. Food and Drug Administration for moderate to severe Alzheimer’s include: 

  • Donepezil (Aricept) 
  • Rivastigmine (Exelon) as a patch 
  • Memantine and donepezil (Namzaric) 

Managing mental health: Depending on your symptoms and health, we may prescribe medications for mood and behavior. These symptoms include depression, anxiety, aggression and sleeplessness. Managing symptoms helps make the patient more comfortable, and supports the caregiver. 

We may prescribe medicines such as: 

  • Citalopram (Celexa) 
  • Sertraline (Zoloft) 
  • Bupropion (Wellbutrin) 

Some sleep, anti-anxiety or antipsychotic medications may be dangerous for people with Alzheimer’s disease. Check with your doctor before taking any new medications. 

Learn more about medications for Alzheimer’s from the  National Institute on Aging.

Complementary and alternative therapies

We may recommend therapies that are complementary (with conventional treatment) or alternative (instead of) to ease symptoms. Providers at the Layton Center work with colleagues at OHSU’s Oregon Center for Complementary and Alternative Medicine in Neurological Disorders. Our research focuses on finding ways to delay or slow Alzheimer’s and other dementias.  

Therapies might include: 

  • Acupuncture: Inserting very thin needles at specific points on the body may relieve pain and other symptoms. Although more research is needed, a 2015 review of studies found that acupuncture is safe and effective for people with Alzheimer’s.  
  • Diet: A low-fat diet with plenty of fruits and vegetables can protect heart and brain health. Research with brain scans showed the benefit of the Mediterranean diet. People who followed the diet had less buildup of an Alzheimer’s-related protein than those on a traditional Western diet.  
  • Meditation: A recent study showed that daily meditation for three months can help people with Alzheimer’s. People in the study showed improvement in memory and thinking. Those who continued for three more months maintained or improved these gains.  
  • Supplements: A few studies have shown modest benefits from taking nutritional or herbal supplements. This is an area of continued research.

Clinical trials

OHSU is at the forefront of research to improve care for patients with dementia. We use clinical trials to test medications, technologies and methods. Recent projects include:

    Three women in hats and gloves, walking outdoors together down a neighborhood street
    • Studying how the brain’s waste-clearing system works so we can find ways to target protein buildup that may cause Alzheimer’s. 
    • Having patients walk through historic neighborhoods to help them stay connected to their community and potentially improve their memory. 
    • Using telemedicine (videoconferencing with a doctor or nurse) to test the mental status of rural residents. 

    Learn more about: 

    Learn more

    For patients

    • Referral: To become a patient, please ask your doctor for a referral. 
    • Questions: For questions or follow-up appointments, call 503-494-7722.

    Location

    Parking is free for patients and their visitors.

    Center for Health & Healing Building 1, eighth floor
    3303 S.W. Bond Ave.
    Portland, OR 97239
    Map and directions

    Refer a patient