Interview with an Alzheimer’s Expert Part II: To be tested or not to be tested

September 13, 2010 by  
Filed under ALZHEIMER'S

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Today, we will continue with our Q & A on Alzheimer’s Disease (AD) with Dr. Michael Rafii and ask about tests for AD.

QUESTION: There are many experimental tests for Alzheimer’s but, there is no still no “gold standard” diagnostic procedure. Currently, the only confirmatory test is by autopsy. Do you think a standardized diagnostic test will be available soon?

ANSWER: Yes, I believe that some combination of amyloid imaging, volumetric MR I as well as cerebrospinal fluid analysis will be utilized for diagnosis of AD, before its symptoms become visible.  There will likely be a need for a screening test, before such a large, and expensive workup is ordered by physicians.

QUESTION: Recently, there was a report about a test that can to detect Alzheimer’s before the symptoms even start. How can this be possible? How can they diagnose a disease with symptoms?

ANSWER: [see above, e.g. referring to answers published in Part I last week]we now have tools such as cerebrospinal fluid analysis and neuroimaging that allow us to measure amyloid in the brain, and are helping us detect AD’s pathology before symptoms show up.

QUESTION: Given that there is no treatment in the horizon, if such a test that detects Alzheimer’s 10 years before it becomes symptomatic ever becomes available, would you recommend patients to get tested?

ANSWER: It is a personal choice.  Some patients are already deciding to get tested with current technology because of a strong family history, and have seen the burden that it places on caregivers.  They want to make financial and legal plans and perhaps make lifestyle changes as well.

QUESTION: If, at age 40, I tested positive for Alzheimer’s using this hypothetical test, are there ways to slow down or even stop the disease before it becomes symptomatic?

ANSWER:  The jury is still out on this.  There have been many studies showing certain types of diets, including the Mediterranean diet, regular physical exercise, and staying cognitively active, may all contribute to lowering the risk of developing AD.  This is an area of tremendous research activity.

About D r. Michael Rafii:

Dr. Michael Rafii, MD, PhD is the  co-director of the Memory Disorders Clinic at UCSD Perlman Ambulatory Care Center in La Jolla, California and Assistant Professor of Neurosciences at the University of California, San Diego. He is also the Associate Medical Core Director of the Alzheimer’s Disease Cooperative Study (ADCS) specializing in cognitive disorders, including dementias such as AD.

About ADCS:

The Alzheimer’s Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego. The ADCS is a major initiative for Alzheimer’s disease (AD) clinical studies in the Federal government, addressing treatments for both cognitive and behavioral symptoms. This is part of the NIA Neuroscience and Neuropsychology of Aging Program’s effort to facilitate the discovery, development and testing of new drugs for the treatment of AD and also is part of the Alzheimer’s Disease Prevention Initiative.

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