Many families are devastated by the development of Alzheimer’s disease in a family member. Although physically present, as this disease progresses, the affected person may not fully recognize those closest to them. As we age, the fear of Alzheimer’s among many of us is ever present. We may find ourselves joking that slight senior moments are the start of our own Alzheimer’s disease.

Over-diagnosis of Alzheimer’s disease is not a joking matter! Alzheimer’s disease was first described in the early 20th century, but we still do not know how to accurately diagnose it while a person is still alive. Current tests tell your doctor is that it might be Alzheimer's, but an accurate diagnosis can only done at autopsy. Since the autopsy rate for seniors is less than 5%, doctors can rarely confirm their diagnosis. It is a diagnosis of exclusion. That means it should not be diagnosed until all other possible causes have been evaluated and ruled out. Although research continues, today there is no accepted test or scan that can definitively diagnose this disease.

Why is this important? Alzheimer's disease is one form of dementia, but there are other possible causes. Alzheimer's is considered progressive and irreversible. In contrast, some other forms of dementia may be reversible or preventable. That is why testing is so important. Comprehensive evaluation can never prove the presence of Alzheimer's disease, but it can rule out the presence of other causes of dementia.

A person's mental capacity can be altered by vitamin deficiencies, poorly controlled diabetes, reaction to blood pressure medications, overuse of psychiatric medication, side effects of gastrointestinal medications, physical stress following surgery or injury, emotional stress or depression, electrolyte imbalance, dehydration, circulatory problems, hormonal problems, cancer, and other problems. Many of these problems can be reversed or moderated. However, that will never happen if all attention is focused on the assumption that this is simply Alzheimer's disease, and therefore irreversible.

I recall decades ago seeing an elderly woman who was admitted to the hospital from a nursing home. Admitted for pneumonia, she was supposedly demented and had not spoken or communicated in any way for years. She was being given large doses of psychiatric medication to keep her calm. I did not give her those, because it seemed unnecessary under the circumstances.

As her pneumonia improved and when psychiatric drugs wore off, she awoke and showed some signs of recognition. She was able to respond to questions in her native language and in a few more days she recognized her family and communicated with them. Since she had been mute for years, her family was astounded. She was discharged from the hospital, fully alert and cognizant to a family thrilled for the return of their matriarch.

Why had this happened? While recuperating from an earlier illness, she was temporarily placed in a nursing home, where no one spoke her language. She became agitated in frustration. The nursing home staff, frustrated by her agitation turned to medication to calm her. This confused her further, which led to greater agitation. That led to even more medication until they had created a docile zombie.

It is frightening to hear this story, yet many of us have seen situations where medical staff seemed too rushed to listen to patients and their families. A tragedy like this could occur in virtually any family. Fortunately, this was reversed, but only after years of loss both to the victim and those around her.

As you see, the details of some reversible causes of dementia can be mistaken for Alzheimer's. This is something to take up with your family physician, but do understand that occasionally, Alzheimer's disease may not be what it seems. Always insist on a thorough evaluation, preferably by a neurologist or internist familiar with many alternate causes of dementia.

Dr. Cohen served as the Chief Resident of Preventive Medicine at Johns Hopkins University, School of Public Health. He is the author of books on topics that include diabetes recovery, weight loss, and addiction. www.PreventionDoctor.com.