The McGowan Institute for Regenerative Medicine faculty member Steven DeKosky, MD, Director of the Alzheimer’s Disease Research Center at the University of Pittsburgh, suggests along with an international group of 18 other neurologists and researchers, that it’s time to change the criteria for diagnosing Alzheimer’s disease (AD). Today, using MRIs, PET scans, and spinal fluid analysis, doctors are becoming increasingly adept at spotting the illness long before symptoms appear.
The suggested guidelines propose that someone with early signs of cognitive impairment be considered an Alzheimer's patient if brain scans or fluid tests have spotted the red flags. Currently, a clinical diagnosis of mild cognitive impairment is not enough to enroll a person into Alzheimer’s treatment studies. Under this revised scenario, DeKosky says, "We'd say you meet the criteria for Alzheimer's disease. Let's start treating you."
With these new guidelines, a patient could then become a candidate for experimental therapies. With an increase in patients, the treatments could be better refined.
Researchers hope that by catching the disease early, the illness can be targeted at its most vulnerable state when effective treatments do emerge. By the time a patient is functioning abnormally, physicians say, the disease is probably too advanced to treat.
Dr. DeKosky also talked about advances in Alzheimer’s research and the implications for treatment as part of the University of North Texas Health Science Center’s Distinguished Speaker Series. Following his presentation, he also participated with local experts on a panel discussing the future of Alzheimer’s care.
“This disease is capable of breaking Medicare and Medicaid all by itself,” DeKosky said. The national Alzheimer’s Association estimates that in 2002, Medicare and Medicaid together spent more than $50 billion on beneficiaries with the disease, and as more people are diagnosed, the spending will go up.
DeKosky said that the awareness of the disease is leading to some of the increase in adults coming in, and he also said that with older adults, signs of Alzheimer’s can be dismissed. “It doesn’t stand out when you’re 85,” he said.
“We haven’t found anyplace that this disease doesn’t occur,” he added. “It’s not like there’s some mythical population in rural Georgia that eats yogurt and never gets dementia.”
Scientists think that up to 4.5 million Americans suffer from AD. The disease usually begins after age 60, and risk goes up with age. While younger people also may get AD, it is much less common. About 5 percent of men and women ages 65 to 74 have AD, and nearly half of those age 85 and older may have the disease. It is important to note, however, that AD is not a normal part of aging. (National Institute on Aging, NIH)
Illustration: McGowan Institute for Regenerative Medicine.
LA Times (10/08/07)
The Lancet (Abstract, Lancet Neurology 2007; 6:734-746)
University of North Texas Health Science Center (09/14/07)
Fort Worth Business Press (10/22/07)
National Institute on Aging, NIH