New Alzheimer's test guidelines urged
BY SHANNON MUCHMORE World Staff Writer
Saturday, April 23, 2011
4/23/11 at 8:24 AM
Go online for more information, or call the Alzheimer’s Association hotline at 800-272-3900.
New guidelines for diagnosing Alzheimer's disease focus on early indicators, including those detectable only by brain scans or other medical testing.
The guidelines, the first new criteria in nearly 30 years, were published this week in Alzheimer's & Dementia: The Journal of the Alzheimer's Association and were developed by the National Institute on Aging and the Alzheimer's Association.
The guidelines discuss measurable substances in the body that can indicate the presence of the disease or risk for developing it later. These biomarkers can be used to determine if people are at risk before they begin to show symptoms.
It was a PET scan that revealed Annette Bell's diagnosis of early-onset Alzheimer's in November. Bell, who does secretarial work in Tulsa, had gone to her doctor after noticing her mind felt fuzzy and she would act strange occasionally.
"I knew something wasn't right with me," she said.
The diagnosis she received, however, shocked her.
She was only 48 and had no history of Alzheimer's in her family. She found out by phone when she was home alone and immediately broke down crying, she said.
"I looked at the mirror and thought, surely this isn't my fate in life," she said. "I had to come to terms with that."
After telling her family, friends and co-workers about the diagnosis, she started learning everything she could about the disease. She visits the Alzheimer's Association in Tulsa frequently to meet with staff and others with her condition.
She is preparing to talk to her family about finances and living arrangements. Her husband and four grown children have all handled the news differently.
Bell is still working full time and pursuing a master's degree. She plans to continue as long as she is able but has trouble thinking when she gets overwhelmed or stressed, she said.
"It's a very 'alone' disease," she said.
About 74,000 people older than 65 in Oklahoma had Alzheimer's in 2010, and the Alzheimer's Association estimates that as many as 96,000 people in that demographic will have it by 2025. In the United States, about 5.4 million people have the disease.
Dr. Jimmie D. McAdams, medical director of the senior diagnostic unit at Laureate, said the new guidelines could help doctors diagnose Alzheimer's earlier.
Most people don't need to get tested for Alzheimer's biomarkers, but those who are at risk for the disease may gain more time for treatment or to discuss care issues with their families if they test positive, he said.
"Even though you might not have symptoms, the chances of you developing Alzheimer's are high," he said.
The new criteria will also advance Alzheimer's research, which could lead to more effective treatments, McAdams said.
Still, there is a concern that a false positive or misunderstanding of the symptoms could lead to undue stress, he said.
"Forgetting your car keys does not mean you have Alzheimer's," he said.
Rhonda Roberts, early-stage coordinator with the Alzheimer's Association in Tulsa, said the guidelines should make early detection easier, although more research is needed.
She suggested healthy people sign up for clinical trials to help researchers in their studies.
"The more we know, the more we can do," Roberts said.
Three stages of Alzheimer's
1. Preclinical: Brain changes may already be in process, but significant symptoms are not yet evident. They may be detected in a research setting by PET scans or other testing.
2. Mild cognitive impairment: Symptoms of memory problems can be recognized but do not compromise a person's independence. Testing the brain and spinal fluid can determine whether it is present, but people who have it do not necessarily progress to Alzheimer's dementia.
3. Alzheimer's dementia: The first symptom is often a decline in cognition, such as word finding, visual or spatial issues and impaired reasoning or judgment.
Source: National Institute on Aging and the Alzheimer's Association
Original Print Headline: Guidelines point to testing for indicators
Shannon Muchmore 918-581-8378