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Wednesday, November 28, 2012

Detecting Alzheimer's disease November 28, 2012

This blog is quoted from part of The NYTimes on November 16, 2012  article "For Alzheimer’s, Detection Advances Outpace Treatment Options" which indicates that the new scan which bacame available in June for testing your brain for amyloids and plaques presents patients and their families with more questions than answers and a positive test result may prevent patients from obtaining long term care insurance.

There are already more than 300 hospitals and imaging centers, located in most major metropolitan areas, that are ready to perform the scans, which are not yet covered by Medicare and cost thousands of dollars.

The scans show plaques in the brain — barnaclelike clumps of protein, beta amyloid — that, together with dementia, are the defining feature of Alzheimer’s disease. Those who have dementia but do not have excessive plaques do not have Alzheimer’s. It is no longer necessary to wait until the person dies and has an autopsy to learn if the brain was studded with plaques.

So it is tempting to get the scan if you feel your loved one is forgetting more than is typical; there is anticipation of relief if the scan is negative, but what if it is positive? There is no treatment available, clinical trials may have significant side effects and the vague fears are then reality. There is nothing more to do, than to get one's affairs in order and prepare to watch our loved one deteriorate slowly.

Scientifically, this is good news if we are sure that the hypothesis is correct. How many scans have been done on non-demented people to show how much plaque is normal? How much of our retirement income or savings should we spend to find out something we can do nothing about? Is it better to wait until the treatment science catches up with the detection science before jumping on the scan bandwagon?

Fear of Alzheimer's disease is the number one fear of illness now in America, overshadowing heart disease and cancer. Let's not let this fear tempt us into rash expensive decisions which could make our lives and those of our loved ones worse, not better.

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