More than 5 million Americans are living with Alzheimer’s disease. Now, for the first time in 27 years, doctors are re-defining how they diagnose the disease in hopes of detecting changes in the brain a decade or more before symptoms occur – a stage when intervention and treatment is believed to be most effective.
The new U.S. diagnostic guidelines released Tuesday by the National Institute on Aging and the Alzheimer's Association, paint the disease as one that emerges gradually over many years, starting with the earliest stage, where someone may not exhibit any obvious symptoms, but might experience abnormal changes in the brain changes in the brain detected only by new brain scans and blood and spinal fluid tests, most still in research settings, not the doctor's office.
This preclinical stage takes place about 10 years before dementia sets in, and is seen as the best place to intervene in the disease. Although the guidelines do not advise doctors to change how they evaluate and treat patients now, many who care for Alzheimer’s patients every day hope the guidelines will prod insurers to expand coverage for additional tests and medical care.
“We know our best chance of finding a treatment or preventing Alzheimer’s lies in our ability to detect changes in the brain at a much earlier stage,” said Bruce Robinson, MD, Medical Director of Geriatrics and the Memory Disorders Clinic of Sarasota Memorial Health Care System. “Treating the disease too late is believed to be the reason for the failure of recent Alzheimer’s trials.”
Symptoms usually begin occurring in the second stage of Alzheimer’s – characterized by mild cognitive impairment, which includes mild memory issues and thinking changes that are enough to be noticed, but aren't debilitating. The last stage for diagnosis is dementia, where memory, thinking and behavioral changes impair a person's ability to function on their own. This stage is toughest on patients and caregivers.
The notion of different stages of the disease marks a stark contrast from the last set of guidelines published by government researchers in 1984, which only recognized the dementia phase of Alzheimer's -- in which people lose their memories and the ability to care for themselves. Many researchers believe most Alzheimer's drugs have failed because they were tried in people whose disease was too advanced to do any good.
For More Information
Call Sarasota Memorial’s Memory Disorders Center at (941) 917-7197, visit our website at smh.com (keyword: Memory) or view a video on Sarasota Memorial’s education channel on YouTube: youtube.com/smhcs