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.