According to the Alzheimer’s Association, someone in the United States develops Alzheimer’s Disease every 67 seconds and by 2050, the number of people age 65 and older with the disease may nearly triple barring the development of medical breakthroughs. In today’s healthcare world, the diagnosis and treatment of this disease involves:
Hearsay Evidence: Talking with the patient and a family member or friend who can corroborate the patient’s memory loss is the first step to determine if physical and cognitive changes are part of the normal aging process or if they are indicative of mild cognitive impairment and Alzheimer's.
Process of Elimination: There is no definitive test for Alzheimer’s despite decades of research. Eliminate other possible causes of memory loss is the first step in diagnosing this disease. Depression is a common disease that occurs as we age and someone with severe depression can appear to have Alzheimer’s. Parkinson’s disease also shares common symptoms. The list goes on, and even sleep medications and analgesics taken for the aches and pains of aging can make us forgetful.
Technology: Not one of the many state-of-the-art medical devices in healthcare today treats Alzheimer’s. They are merely tools we can use to confirm a diagnosis. MRI brain imaging can help rule out hydrocephalus and benign or malignant tumors as well as damage caused by silent strokes. Low-tech blood tests are used to uncover low thyroid, vitamin deficiencies and liver and kidney conditions that can cause memory loss.
Pills, Patches and Ipods: Although research has failed to give us a good medication, it has created multiple lines of treatment which offer, if anything, modest improvement. The FDA has approved medications from two classes (cholinesterase inhibitors and memantine), and alternative treatments include vitamin and food supplements. While many of these can be quite expensive, increasing socialization, exercise and just listening to music have also shown improvement in brain function.
Research: As with diagnosing the disease, research to date can be seen as ruling out possible biological markers or genetic profiles. MRI’s are looking at the size of memory centers in the brain as PET scanning is being performed to understand if abnormalities in glucose metabolism create plaques in the brains of older individuals. Genetic research is investigating the apolipoprotein E (APOE) gene found on chromosome 19. According to the NIH’s National Institute on Aging, most researchers believe that APOE testing is useful for studying Alzheimer's disease risk in large groups but not for determining an individual’s risk. In practice, APOE testing is considered for patients with a family history of early-onset Alzheimer's disease but is not generally recommended for people at risk of late-onset Alzheimer's.
Dr. Eduardo R. Locatelli is the medical director of the Holy Cross Neuroscience Institute and of Holy Cross Hospital’s Epilepsy Monitoring Unit. For referral information, call 954-776-9517.