As an elder law attorney, I see first-hand the devastation that Alzheimer’s disease causes for patients and their caregiving families. For many years, the prevailing thought was that you can’t fully diagnose Alzheimer’s disease until after the patient has passed with an autopsy. In the last several years, MRI tests have been used that are very effective in diagnosing Alzheimer’s and PET scan tests are also commonly used. But, these tests are still expensive, and for many people they can be fairly traumatic experiences, particularly an MRI. Some recent studies may have developed an easy, non-invasive way that had really remarkable results.
At a conference on Alzheimer’s earlier this month, two groups of studies were reported that could be used to lead to earlier and more accurate diagnosis results. In the first group of studies, an ointment was applied to the eye, and then a laser scan can detect levels of beta-amyloid proteins. It has been known for some time that these proteins are what start to build up, leading to the plaques in the brain that is indicative of Alzheimer’s, and also what is believed to cause the loss of cognitive functioning in Alzheimer’s patients. These proteins are present for a significant period of time before the plaques start to form. They tested 40 people, 20 of whom were not suspected of early stages of Alzheimer’s and 20 who were diagnosed. The test correctly identified all 20 people who had, and didn’t say any of the healthy 20 had the proteins (which is called a false positive).
In the second study, a little over 200 people who had already been diagnosed with Alzheimer’s were tested for being able to identify different scents and those test scores were compared against the test scores of a similar sized group of people who were not diagnosed with Alzheimer’s. The group with Alzheimer’s performed significantly worse than the other group at identifying different scents. The thought is that these scent tests would not be enough to diagnose someone by themselves, but they could ultimately prove to be an inexpensive, easy test to decide whether or not to perform further, more expensive, and more intrusive tests.
Why is it important to be able to diagnose Alzheimer’s early-on, since there is no cure for the disease? The primary reason for this is that most of the current medications and treatments that are close to being able to be distributed to the public are not designed to cure the disease, but rather to slow the progression of the disease down- sometimes significantly. Additionally, the medicines that are currently available do have occasional severe side effects in some people, so dispensing the medication to someone who does not have Alzheimer’s can subject the person to these side effects, without any real hope of improving symptoms. But the medications, when effective, are the most effective at slowing the progression of early onset Alzheimer’s- they have much smaller effect on people with moderate to severe symptoms. So, the earlier you can get an accurate diagnosis, the earlier you can start on the medicines, which will hopefully extend the period where the symptoms are mild, and the person can still have a high quality of life before the really pronounced cognitive impairment sets in that is so commonly associated with Alzheimer’s.
As with all of these studies, they are one of the first steps- larger studies are needed to figure out if the study was a fluke, or if this is a real breakthrough. It will still be several years, even in the best case scenario, before these tests would be commonly used.