New Guidelines for Alzheimer’s Diagnosis Proposed

It seems that hardly a week goes by these days without a front page article in the New York Times about Alzheimer’s Disease. Today’s piece addresses a proposed revamping of the way Alzheimer’s is diagnosed: specifically, it would reflect advances in brain imaging that can now be used to detect brain evidence of dementia years before actual clinical evidence. Dr. Paul Aisen, a well-known Alzheimer’s researcher who is working on the proposed guidelines, observed that “we now view dementia as a late stage in the process.” He predicts that people in their 50′s without any evidence of memory loss or other cognitive problems will routinely have tests such as MRI scans or spinal taps that will predict their likelihood of developing Alzheimer’s disease: by then we will hopefully have medications that can be administered to prevent or delay its onset.

The success of this strategy really hinges on having medications available that alter the course of the disease. Although no drugs have yet been shown to delay or prevent the onset of Alzheimer’s, there are other advantages of early diagnosis. People have more time to put into place financial plans, health care proxies, and living wills. Families may be more vigilant about identifying signs of depression or anxiety that often accompany early dementia and may be treated. Some people may of course not want to know whether they will develop dementia down the road, and what good is it really to tell someone they’re going to get dementia but not having anything substantive to offer to manage it?

While I’m amazed at how good these imaging studies are and how our thinking about diagnosis is evolving, I’m not convinced we’re prepared to implement these changes. Possible ripple effects mentioned in the article include unintended consequences for lawyers, insurance companies and workers’ compensation programs. And having more reasons for expensive brain scans and tests is not exactly what our health care system needs at this point. Please share your comments.

http://alzheimers.about.com/b/2010/07/14/new-guidelines-for-alzheimers-diagnosis-proposed.htm

This entry was posted on Friday, July 16th, 2010 and is filed under Kesehatan. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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