Monday, April 9, 2012

Would You Want To Know Early?

A new test developed by Eli Lily & Co. that detects the presence of proteins in the brain that are related to Alzheimer's disease was approved Friday by the Food and Drug Administration.  Previously, Alzheimer's was only definitively diagnosed after death, through autopsy of the brain.

Before I get to the test, let me start with a note of positivity. Many people think that dementia is an inevitable result of aging. This is not true. Dementia only affects 1 out of 8 people above the age of 65 and only 3 out of 7 above the age of 85. That means that more than half of the people who live past the age of 85 do not develop dementia.That's important to remember! Also, while Alzheimer's is currently not effectively treatable, other forms of dementia representing about a quarter of dementia cases may have effective treatments and a number of other conditions which may resemble Alzheimer's may also be treatable.

So it would seem that this test would be well received.

However, the new test is stirring a bit of controversy primarily because there are no good treatments for Alzheimer's and therefore some question the value of early diagnosis. Others, including doctors, believe that early diagnosis is valuable because it will give people time to plan out their lives. Also, because the diagnosis of Alzheimer's is often made on general subjective clinical findings and not specific objective findings like blood results or other diagnostic tests, this new test allows for the first time for definitive diagnosis.

I agree with those who think the test is a valuable addition to doctors' diagnostic arsenal in identifying and battling this horrific disease. Early diagnosis will also allow researchers to develop more effective treatments for the disease and maybe some day to find a cure. As Alzheimer's is a lethal disease which strips people of most cognitive ability before denying life, I agree with many others that it would be prudent to give one ample time to arrange his or her affairs. In this case, Alzheimer's is unfortunately no different than wanting to know you have terminal cancer as soon as possible.

Also, definitive diagnosis may be of utmost importance because there are several disease that present like dementia such as delirium, and there are several forms of dementia including one called vascular dementia (muti-infarct dementia). Unlike Alzheimer's, vascular dementia is treatable and more importantly, it is not necessarily a progressive disease.

More excitingly, although a precise link has not been identified between Alzheimer's and lifestyle, scientists grow more confident that such a relationship exists.  For vascular dementia, the link is absolute. The same principles that apply to heart health, apply to this disease which consists of mini-strokes that destroy small parts of the brain in a cumulative fashion. This progressive destruction ultimately fully robs one of cognitive ability and other key brain functions. The major take-away is therefore, protect your heart, protect your head. Eating properly, staying physically active, managing stress, and getting 7-8 hours of sleep per night reduces the development and progression of these vascular events that mirror heart attacks.

For the rest of Alzheimer's, there is a 60% correlation between Alzheimer's and high blood pressure. The presence of diabetes and depression versus diabetes alone doubles the relative risk for developing dementia. These findings demonstrate the relationship between Alzheimer's and other diseases related to lifestyle.

So even though today doctors and scientists do not know with certainty how to prevent and treat Alzheimer's, it would seem prudent to live your life in such a healthy manner as to decrease the risk of vascular dementia and maybe even Alzheimer's itself.

If you know someone who has early clear symptoms of short-term memory loss, you should consult with a doctor and consider this test. In the interim, let's all hope and pray that a breakthrough discovery for this disease will come soon.

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