More should be done now to diagnose Alzheimer’s
(treatments are at best palliative)
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A recent Harvard School of Public Health survey of more than 2500 adult in six different countries has found that Alzheimer’s disease is more dreaded than any other disease save cancer. The same survey also demonstrated that 85% of respondents would want to know their diagnosis as soon as possible if they began to show symptoms. The survey was reported recently at the Alzheimer’s Association International Conference (AAIC) meeting in Paris, France.
At this time the diagnosis of Alzheimer’s disease is a clinical one, as there is no reliable diagnostic test. Many researchers are hard at work developing tests that detect Alzheimer’s disease earlier in its course. Research presented at the AAIC aimed at earlier detection included studies of modalities such as MRI, PET scanning to detect the amyloid protein thought to mediate cognitive decline, and tests of spinal fluid for amyloid or other putative toxic protein products. Researchers hope that earlier detection will spur the development of new drugs to prevent or treat this truly horrifying disease.
All this emphasis on earlier detection places in sharp relief a dirty little secret about the diagnosis of Alzheimer’s – physicians frequently don’t diagnose Alzheimer’s, even in patients who have had the disease for years.
As a geriatrician, I’m frequently asked to evaluate patients with memory loss and other geriatric syndromes. Most of these patients see their primary physicians faithfully for treatment of hypertension, diabetes, hyperlipidemia and other chronic diseases common in older adults. By the time the family has brought the patient to me for an evaluation of memory loss, signs of cognitive decline usually have been present for many months or even years. These signs include poor compliance with prescriptions, inability to perform instrumental activities of daily living, or asking the same question repeatedly. Not only do these patients score poorly on standardized mental status instruments, but they often don’t remember their ages, birthdays, former jobs, or how many grandchildren they have. In other words, with few exceptions, the diagnosis of Alzheimer’s disease is not difficult to make, especially in patients whose disease has been present long enough to reach the moderate stage. Continue to read: kevinmd.com
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