A Test for Alzheimer’s?

Panels of experts convened by the National Institute on Aging and the Alzheimer’s Association have developed new guidelines for the detection of Alzheimer’s disease. Using the old guidelines to diagnose Alzheimer’s , Doctors must substantiate and identify a steadily progressing dementia  and an inability to carry out day to day activities like dressing or bathing. This must be accompanied by a pathologist’s report of plaque and other abnormalities known as tangles discovered in the brain after death.

But researchers claim that by using new methods, Alzheimer’s can be identified a decade or more before dementia sets in. Under the new guidelines diagnoses will be made by using results from what are called “biomarkers”. These biomarkers are tests such as brain scans, M.R.I. scans and spinal taps that reveal telltale brain changes.

Scientists claim that these biomarkers can identify three stages of dementia, preclinical disease, mild cognitive impairment due to Alzheimer’s disease and lastly Alzheimer’s dementia. They state that diagnosis of people in the final stages of the disease will be much more definitive using biomarkers. But they also state that the earlier a diagnosis is made the less certain it is.

What are the implications of this research? For those of us with Alzheimer’s  disease in our family it opens up all kinds of questions. Some experts tell us that 50% of adult children whose parents have Alzheimer’s will also contract the disease. Should we go through the biomarker testing? What if it reveals that we are in the preclinical stage? Do we change how we live our lives? Do we seek some kind of treatment or start doing more crossword puzzles? There clearly is no present cure, so are we just giving ourselves an early death sentence?

Other implications for the use of these research techniques may evolve. Will insurance companies start using them to determine if you should be covered for health, life or long term care insurance.? And even if the tests are not totally accurate will the insurance companies use them to reduce their risk?

Using the biomarkers scientists believe they can develop drugs that can control or cure Alzheimer’s. Dr. William Potter, a neuroscientist at Eli Lilly stated “We wanted to get out of what I called 19th century drug development— give a drug and hope it does something. What was needed was to find some way of seeing what was happening in the brain as Alzheimer’s progressed and asking if experimental drugs could alter the progression.”

For the time being however, I have decided that I really don’t want to know if I am in the early stages of Alzheimer’s.  I’m just going to live my life as if every day mattered. And I’ll continue to provide love and care  to my Alzheimer’s mom.

The IPad and Alzheimer’s

My mom was diagnosed with Alzheimer’s disease approximately 4 years ago. Fortunately she is still quite alert and has a very sweet, loving disposition. She often refers to the aides and her fellow residents at Harbor Point as “dearie”

I talk to her a lot about her friends and relatives who have written to her or called her. Often she becomes confused when she tries to remember what they look like or who they are. I have found that showing her a photo of that person when I mention their name takes away a lot of the stress and frustration and she recognizes the person right away

Recently we celebrated her 90th birthday at a local restaurant. 12 people from the family joined her at the party. One of her nieces (Cheryl) was kind enough to give her a gift card to her favorite restaurant (Ninety Nine) and she was just thrilled.

My wife, Mary took a number of pictures of everyone who attended the party and I loaded these pictures onto my iPad. When I visited mom the week after the party I mentioned what a wonderful gift her niece, Cheryl had given her. She was confused and thought it was another niece who had given her the gift. I immediately opened up the iPad, showed her the pictures of the party and pointed to Cheryl. “There she is, right after she gave you the gift.” Mom recognized her and acknowledged how nice it was of her to be so generous.

I have often used pictures from my iPad to put Mom back in touch with the important events and people in her life. Several years ago I borrowed all my parents’ old photo albums and scanned hundreds of pictures into IPhoto on my computer. My dad had been a real photo buff and often developed many of his own pictures. Several of these pictures were classic shots of both my parents when they were quite young. I have a wonderful photo of my mom in her beautiful white high school graduation gown. She looks absolutely stunning! I’ve also got several pictures of mom and dad as young sweethearts.

I downloaded hundreds of these pictures onto my iPad and divided them into several albums representing different periods in my Mom’s life. When we are talking she’ll often ask questions like ”When did you get married? Was I there?” I can then go directly to the pictures of our wedding and show her that she was in fact there and looked quite attractive. We will often go through a number of pictures from her past and discuss the events around them. She loves to look at pictures of my father when he was a sharp young soldier during WWll. That leads into extensive conversations abut how great a father and husband Dad was.

The iPad is so easy to share pictures with her. The photos take up the whole screen and are quite clear. We can make pictures smaller or larger by squeezing or extending our fingers on the screen. Mom can change photos by just brushing her finger across the screen or tapping it. It is such a wonderful tool to share memories with her.  Frankly I don’t know how I’d share all these memories with her without it. The iPad enriches each visit we have together. And that has made all the difference.