Whether there's any point in taking advantage of testing to diagnose Alzheimer's disease early and whether there are preventive steps that really matter are among the debates that emerged from an international conference focused the disease this week.
It's an important issue that matters to Americans and Europeans, according to one study presented at the confab in France. Repondents said they fear Alzheimer's only a little bit less than they fear cancer. A phone survey of 2,678 adults across the U.S.. And Europe found that a quarter fear getting the disease and more than 85 percent said they'd see a doctor for signs of memory loss, while 94 percent said they would encourage family members to do so, according to an article in International Business Times.
"Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the result," according to USA Today.
There are new ways to test, including brain scans, an eye test and a blood test, and more on the way. But the thinking behind the opposition to testing comes from multiple trains of thought:
— Some of the tests will find brain plaques that will likely not turn into the dreaded Alzheimer's, which is the most common form of dementia, impacting 5 million Americans. It could be unnecessary expense and stress.
— Even if it is actual Alzheimer's, there is no cure. Drugs can help about half of patients with the symptoms, but only in the short-term. Here experts divide, some advocating providing early help if possible and others saying bascially that if there's no cure, there's no point.
— There are conditions, including sleep disorders, thyroid troubles, vitamin deficiency and depression — all treatable — that can mimic Alzheimer's, so screening can lead to a real diagnosis and provide help.
USA Today noted that "testing someone with symptoms is far less controversial than testing people with no symptoms, but a lot of fear. Doctors worry that these newer methods, such as an easier type of brain scan that's expected to be available within months, will be directly marketed to the public, prompting expensive and excessive testing based on fear."
The conference also highlighted the fact that some researchers believe Alzheimer's, for many, is not a genetic foregone conclusion. At the international conference, researchers said half of cases are at least impacted by lifestyle choices and outlined seven things people can do in mid-life to reduce the risk later of developing Alzheimer's, according to a report on MSNBC.com. Those include not smoking or stopping if you already smoke, increased physical activity, more mental activity, controlling blood pressure and diabetes, and managing obesity and depression, it said.
MSNBC quoted researchers: "Given the current absence of disease-modifying treatments, as well as increasing awareness that symptoms develop over many years or even decades, there has been growing interest in identification of effective strategies for prevention of [Alzheimer's disease], wrote Deborah Barnes and Kristine Yaffe, researchers at the University of California, San Francisco (UCSF).
But hope that the disease can be prevented is not proof that it can be prevented, according to other researchers, In April of 1010, National Institutes of Health State-of-the-Science Conference looked solely at risk factors and possible preventive measures for Alzheimer's and concluded that the only factors absolutely proven to affect risk of Alzheimer's are beyond control: age and genetics.
Reporting on that group's findings, MyHealthNewsDaily reporter Rachael Rettner noted that even the absence of certainty doesn't mean people should not pay attention to potential risk factors and modify them. "Does this mean there's nothing you can do to prevent Alzheimer's? Not exactly. There could well be ways to prevent Alzheimer's that are within our control, the researchers say. But more rigorous, long-term studies need to be done to solidify the link between these factors and Alzheimer's disease risk," Rettner wrote.
And they certainly improve health in other ways, whether or not they directly impact Alzheimer's risk.
Other research presented at the conference found that most of those diagnosed with mild dementia also suffer apathy and depression. They needed more help and were less independent. In those cases, early testing might provide important interventions.
"Our study highlights the size of the problem of apathy and depression in newly diagnosed patients and shows what a devastating impact this can have," says Philippe Robert, Centre Mmoire de Ressources et de Recherche (CMRR) de Nice. "We already know that these symptoms are the most frequent neuropsychiatric manifestations in Alzheimer's disease, but this is the first time that the frequency has been observed using specific diagnostic criteria. We also know that people with apathy or depression and mild cognitive impairment have an increased risk of developing dementia, thus re-iterating the importance of intervention in helping delay the onset of Alzheimer's disease and the common neuropsychiatric conditions associated with it." He adds: "Early management and diagnosis of Alzheimer's disease using cognitive and neuropsychiatry signs might allow patients to remain independent for longer."
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