AlzheimerÂ’s disease early detection close

A blood test that could warn somebody if theyÂ’re at risk for developing AlzheimerÂ’s disease could be on the horizon within five to 10 years, said Dr. Steven DeKosky, an expert and researcher of the disease.

DeKosky, director of the AlzheimerÂ’s Disease Research Center at the University of Pittsburgh, talked about advances in research of the disease and the implications for treatment. The presentation by DeKosky was part of the UNT Health Science CenterÂ’s Distinguished Speaker Series, which took place on Oct. 16. After the presentation, he and a panel of local experts further discussed the future of AlzheimerÂ’s care.

“We’re probably where cardiac docs were in the ‘60s,” DeKosky said

of AlzheimerÂ’s research. By the

1970s, though, cardiac specialists saw a dramatic drop in deaths due to better treatment and prevention of heart disease, and DeKosky said research

currently being done about AlzheimerÂ’s could soften the blow to the health care system as the baby boomers become older.

“This disease is capable of breaking Medicare and Medicaid all by itself,” DeKosky said. The national Alzheimer’s Association estimates that in 2002, Medicare and Medicaid together spent more than $50 billion on beneficiaries with the disease, and as more people are diagnosed, the spending will go up.

AlzheimerÂ’s disease, which affects more than 5 million Americans, was first described by Dr. Alois Alzheimer in Germany, who treated a woman named Auguste, who became the first recognized AlzheimerÂ’s disease patient.

The problems with recall and memory in AlzheimerÂ’s patients come from two abnormalities that form in the brain: plaques and tangles. Plaques are formed by long chains of proteins that deposit in the spaces between brain cells, and tangles are made of abnormal proteins inside brain cells and are associated with cell death.

“You can have Alzheimer’s disease without tangles, but you can’t have Alzheimer’s disease without plaques,” DeKosky said.

Plaques and tangles, seen during an autopsy, used to be the only way to definitively diagnose AlzheimerÂ’s disease, he said. But over time, health care professionals became adept at using mental assessments and brain scans to confirm the diagnosis and start treatment on patients.

The plaques and tangles account for the strange behavior of AlzheimerÂ’s patients, who are sometimes stereotyped as doing strange things, such as putting car keys in the freezer or wandering off from their homes.

“This is a brain that misinterprets information and acts on it,” DeKosky said, which is different from most types of dementia.

Catching AlzheimerÂ’s early by screening people for mild cognitive impairment (as determined by mental assessments) could significantly help by treating the disease quickly. Every year, about 13 percent of people with mild cognitive impairment develop dementia, although not all of them specifically develop AlzheimerÂ’s disease, he said.

Some researchers in Sweden have found a way to test spinal fluid for the proteins associated with plaques and tangles, and they were able to predict who would develop AlzheimerÂ’s disease with about 85 to 90 percent reliability.

“This is a very small test, though,” DeKosky said, and too soon to tell whether it will hold up in everyday use.

Other research teams are looking at ways to develop immunizations against plaques, which can be detected in people 10 to 15 years before they may develop dementia, including AlzheimerÂ’s disease. Drugs are also being tested for their effects at slowing down the progression of the disease.

During the panel discussion, Theresa Hocker, executive director of the North Central Texas Chapter of the AlzheimerÂ’s Association, said that younger and younger adults are coming in seeking information about the disease.

“It’s just overwhelming each time someone in their 40s or 50s comes in and is facing this disease,” she said.

DeKosky said that the awareness of the disease is leading to some of the increase in adults coming in, and he also said that with older adults, signs of AlzheimerÂ’s can be dismissed.

“It doesn’t stand out when you’re 85,” he said. “We’re more inclined to say, ‘Oh, well, they’re 85.’”

While researchers continue to explore treatment and prevention options, itÂ’s up to physicians to screen patients for signs of the disease and people to increase awareness, he said.

“We haven’t found anyplace that this disease doesn’t occur,” he said. “It’s not like there’s some mythical population in rural Georgia that eats yogurt and never gets dementia.”

Contact Bassett at ebassett@bizpress.net