Detective Work: The False Alzheimer’s Diagnosis

Family members of J.D. “Jasper” Cain suspected he had Alzheimer’s disease as they watched the once fun-loving father and husband struggle with memory and movement. Three doctors thought he had Parkinson’s disease and kept raising his medication dose when he didn’t improve.

At his daughter’s suggestion, Mr. Cain, of Bedford, Ind., saw a neurologist last year who did an MRI, then a spinal tap. He found that Mr. Cain had a buildup of fluid in the brain called normal pressure hydrocephalus. The fluid was drained with a surgically implanted shunt. Now, 13 years after his symptoms began Mr. Cain, 70, is walking, joking and matching wits with TV’s “Jeopardy” again. “It was just like getting my life back,” he says.

More than 100 other conditions, from vitamin and hormone deficiencies to rare brain disorders, can mimic Alzheimer’s disease, experts say. Some are readily treatable.

Alzheimer’s symptoms such as confusion, memory loss and personality changes also can be side effects from medication—even commonly used drugs. For example, the entire class of anticholinergic drugs, which includes many antihistamines, antianxiety drugs, muscle relaxants and sleeping pills, block the brain chemical acetylcholine, which sends signals in the nervous system. It is the same chemical that many Alzheimer’s medications boost. Cholesterol-reducing statins have also been linked to brain fog in some people.

In many cases, the cognitive symptoms vanish when medication is stopped. “I have had people referred to me with a clear history of dementia and when I started to peel back the medications, they were much better,” says Gary Kennedy, chief of geriatric psychiatry at Montefiore Medical Center in the Bronx, N.Y.

It isn’t just primary-care physicians who may miss underlying conditions. “Every Alzheimer’s expert living today has been fooled,” says P. Murali Doraiswamy, chief of biological psychiatry at Duke University Medical Center in Durham, N.C.

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