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New Alzheimer's Guidelines Proposed

Posted Jul 30 2010 6:00am
From the New York Times - New diagnostic guidelines presented at an international Alzheimer’s meeting in Hawaii would mean that new technology like brain scans would be used to detect the disease even before there are evident memory problems or other symptoms. Some experts predict a two-to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it.

The current formal criteria for diagnosing Alzheimer’s require steadily progressing dementia and an inability to carry out day-to-day activities, like dressing or bathing — along with a pathologist’s report of plaque and another abnormality, known as tangles, in the brain after death.

But researchers are now convinced that the disease is present a decade or more before dementia.

The new guidelines include criteria for three stages of the disease: preclinical disease, mild cognitive impairment due to Alzheimer’s disease and, lastly, Alzheimer’s dementia.

Under the new guidelines diagnoses will aim to identify the disease as it is developing by using results from brain scans and spinal taps that reveal telltale brain changes. One of the newest, a PET scan, shows plaque in the brain — a unique sign of Alzheimer’s brain pathology.

Of course all this has implications.
  • More testing means more medical costs.
  • More testing will likely reveal higher incidences of the disease.
  • More testing will also lead to false positives as well, scaring those who need not be worried.
  • It moves researchers closer to the source of the disease and therefore a path for a cure.
  • The new diagnostic criteria will have consequences for lawyers, insurance companies and workers’ compensation programs.
Part of me applauds this but frankly if you tell me I have Alzheimer's or am on the road to getting it at 53 and you have no cure than perhaps ignorance is bliss. Perhaps I don't want to know. But that is a choice I can make by not undergoing the tests being recommended. The other side of me grapples with my whole platform, educated aging choices sooner in life. After all couldn't you plan better for yourself and loved ones knowing what you know? Hard call.

Your thoughts please....
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