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Alzheimer's Misdiagnosis & the Benefit of a Radiology Second Opinion

While Alzheimer’s Disease accounts for the majority of neurocognitive disorders, research has shown the misdiagnosis rate to be alarmingly high.

In a study that examined the diagnosis of over 900 patients, it was found that one in four patients had an Alzheimer’s misdiagnosis - with an even split between false positives and false negatives.

DocPanel is committed to making sure patients get an accurate diagnosis. Our fellowship-trained neuroradiologists have extensive experience in detecting and diagnosing Alzheimer's and other neurological diseases. If you or a loved one is navigating a diagnosis and would like a second opinion on medical imaging, you can learn more here.

Diagnostic Challenges That Can Lead to an Alzheimer’s Misdiagnosis

Diagnosing Alzheimer’s disease is a complex and tricky process. Diagnosis is largely based on symptoms - but the signs of Alzheimer’s overlap with a number of other conditions, many of which may be treatable and even possibly reversible. With no blood test or imaging exam that can confirm the condition with 100 percent accuracy, preventing an Alzheimer’s misdiagnosis relies heavily on the expertise of a patient’s healthcare provider.

Alzheimer’s disease is a progressive disease, with the beginning stages including the inability to retain new information and later stages advancing to confusion, disorientation, and loss of normal functions such as walking and swallowing. Other medical conditions, such as vascular dementia and Parkinson’s disease, similarly affect mental functions making it difficult to make a clinical distinction.

"It's not uncommon for people to be diagnosed with Alzheimer's and end up having Lewy body dementia, which is a combination of symptoms that look like Parkinson's disease but involve hallucinations and significant behavioral changes," says Aimee Chagnon, MD, a neuroradiologist from California and Second Opinion radiologist for DocPanel.

An Alzheimer’s misdiagnosis can lead to undue stress for those who don't have the disease but are told they do, and delays in treatment for others who do have it but are told they do not.

"The other thing we often see is people being misdiagnosed with Alzheimer's who actually have frontotemporal dementia. Normal-pressure hydrocephalus (excessive fluid on the brain) is another condition that causes memory and balance problems that mimic Alzheimer's. The difference being that hydrocephalus can be treated when caught early on," explains Dr. Chagnon.

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Preventing Alzheimer’s Misdiagnosis

Medical imaging has huge potential to improve accuracy and early detection. Brain imaging with MRI, SPECT, and PET can capture tell-tale signs of structural and functional cerebral alteration within the brain. It helps neuroradiologists learn patterns that support accurate detection so that other forms of dementia can be ruled out before making a definitive diagnosis.

In a study published in the Journal of the American Medical Association (JAMA), researchers found that performing PET scans resulted in an altered diagnosis for one in three study participants with dementia or memory problems and change management (medications, therapy, counseling, etc.) in two-thirds of patients.

The study also showed that Alzheimer’s misdiagnosis could be identified through imaging when it revealed a lack of amyloid buildup. For the same reason, half of the patients who had not been diagnosed with Alzheimer’s received a new diagnosis based on PET scan results.

The Value of a Second Opinion

While medical scans can strengthen accuracy and prevent Alzheimer’s misdiagnosis, advanced imaging such as PET can be challenging to read. Even if your scans were initially read by a subspecialty radiologist, it's a good idea to have a second set of eyes review your scans. A second opinion can lead to quicker realization and quicker treatment, or conversely, an immediate halt on unnecessary treatment from an Alzheimer’s misdiagnosis.

A study published by the RSNA titled "Second-Opinion Consultations in Neuroradiology" states that "offering second-opinion interpretations represents a major opportunity for neuroradiology services in tertiary care centers to improve patient care." The findings presented in this study are reassuring to patients that second opinions are beneficial because "the second-opinion consultation was more accurate than the outside interpretation in 84.0% of studies."

In addition to emotionally and physically taxing effects on misdiagnosed patients, there is the added aspect of medical costs for Alzheimer’s misdiagnosis. Getting an Alzheimer's second opinion will not only give you peace of mind but will also ensure that you pursue the right treatment plan moving forward.

If you or a loved one has been diagnosed with Alzheimer’s Disease, check out our roundup of Alzheimer's support groups to connect with in-person meet-ups, financial planning tools, and more.


Other references:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312396/#A006213C28

https://www.appliedradiology.com/articles/the-role-of-pet-in-dementia-diagnosis-and-treatment

https://www.alz.org/alzheimers-dementia/what-is-alzheimers

https://www.alzheimers.net/resources/alzheimers-statistics/

https://www.alzinfo.org/pym/feature/rule-opinions/

https://pubs.rsna.org/doi/pdf/10.1148/radiol.09090831

In this article...

Diagnostic Challenges That Can Lead to an Alzheimer’s Misdiagnosis Preventing Alzheimer’s Misdiagnosis The Value of a Second Opinion

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