The good news, doctors say, is that with early detection, a diagnosis of Alzheimer's need no longer be as ominous as it once was feared. Further-more, there are promising new developments that could allow doctors to detect—and possibly treat—the illness years before symptoms develop. Perhaps the most notable, presented in July at a conference in Stockholm, is the use of PET scans of the brain. "For the first time we can actually see the physical evidence of the disease in the living patient," says Dr. Gary Small, a UCLA Alzheimer's researcher whose team has devised such a method. "This is a very exciting time."
Although these scans may not be available to the public for several years, a thorough clinical evaluation can already help doctors recognize the earliest stages of AD. And once diagnosed, new medications may slow the disease's progression. Correspondent Barbara Sandler spoke with Dr. George T. Grossberg, 53, director of Geriatric Psychiatry at St. Louis University School of Medicine and one of the nation's top Alzheimer's experts, about these advances.
What causes Alzheimer's?
An excess of a brain protein called an amyloid, which forms plaque in the brains of AD patients. These plaques interrupt the ability of nerve cells to communicate with each other and cause cell death. What we don't know is what causes the plaques to form.
How do the new scanning techniques work?
Researchers at the University of Pittsburgh have developed a test that uses a radioactive dye to "light up" the amyloid protein, which may help confirm a diagnosis of AD. Recently, scientists at UCLA found that by injecting a radioactive tracer into a patient, they could find minor decreases in brain-cell activity, which can help predict AD up to a decade before the onset of clinical symptoms.
What other methods are there for detecting Alzheimer's?
By asking the right questions [see box] in a clinical setting, we can detect mild cognitive impairment [MCI] or certain short-term memory problems in people as early as their 50s. We know that 30 to 50 percent of people who have MCI will develop AD within five years. Some, though not many, patients with MCI are now taking drugs to fend off Alzheimer's.
Are there any other ways to help prevent AD?
We're learning a lot about the relationship between cardiovascular risk factors and later development of AD. By getting hypertension, diabetes, high cholesterol, smoking and weight under control, people may be able to decrease their risk of AD. There's also evidence that the cholesterol-lowering statin drugs can help, as well as antioxidant vitamins like C and E. Folic acid may be helpful too.
Given a positive AD diagnosis, what treatment options are available?
In AD, the level of acetylcholine, a chemical in the brain linked to impaired memory or intellect, is deficient. Right now there are four medications—Exelon, Aricept, Reminyl and Cognex—that slow acetylcholine's breakdown in the blood. Research suggests that by taking these drugs early enough, you can relieve serious symptoms of AD.
The good news is that AD is not a death warrant. You can still have many years of quality life, especially with proper treatment.
- Contributors:
- Barbara Sandler.
Saved by the Bell Reunion
The hookups, the meltdowns, the memoires
The case reveals what was really going on what they think of each other now!
