Getting a realistic picture of the extent of Alzhiemer’s disease is important, and it’s one that we don’t have at this point. Sure, a large number of people are diagnosed with the disease, but now that researchers believe that the disease can begin to attack the brain at least 10 years before signs of its progression have shown up. Having a better understanding of the numbers of people who are in the silent phase of the disease (when no memory loss is occurring) could be critical in galvanizing politicians and other stakeholders into doing what is necessary to fight this disease. It also would help drug companies do a better job of developing targeted medications that can help people in the earliest of stages.
Therefore, it’s interesting to see that the National Institute on Aging and the Alzhiemer’s Association are working together to update the diagnostic criteria for the disease. The draft reports were presented at the Alzheimer’s Association International Conference on Alzheimer’s disease.
The Alzheimer’s Association blog notes that the current criteria currently being used were established in 1984. That was about the time period that my maternal grandmother died from Alzheimer’s. Yet at that time, we didn’t have a diagnosis for Grandma’s malady. In a note listing family health issues that she wrote around 2000, my mom said, “I’m saying Alzheimer’s, but it could have been just senility – except Grandmother’s symptoms were the same as her roommate in the nursing home who was diagnosed as having Alzheimer’s.” Thinking how much time has elapsed since Grandma’s death, it’s surprising to me how long the criteria has remained without modification, especially since the knowledge of Alzheimer’s has evolved tremendously.
At the Alzheimer’s conference, preliminary reports were given based on the efforts of three workgroups which focused on Alzheimer’s disease dementia, mild cognitive impairment (MCI) due to Alzheimer’s disease, and preclinical Alzheimer’s disease. "The proposals would change the 1984 criteria by better reflecting the various stages of the disease and the inclusion of Alzheimer's disease biomarkers," said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's Association. "While the role of biomarkers differs in each of the three stages, much remains to be understood concerning their reliability and validity in diagnosis. This makes it critical that we thoroughly test any new recommendations."
The three workgroups offered new ideas for research criteria and ways to better define the early stages of Alzheimer’s. These ideas are:
- The pre-clinical group is developing a research agenda focusing on identifying methods of assessment that can help predict a person’s risk for the disease. These assessment tools, including biomarkers, which could be used to identify early cognitive decline to determine if Alzhiemer’s is present in people who show no overt symptoms.
- The group focusing on MCI is refining the criteria in order to identify cognitive change prior to dementia. In addition, this change will do a better job of differentiating between MCI and Alzheimer’s.
- The group focused on Alzheimer’s disease is revising the current criteria for diagnosis. The revisions will include possible biomarkers and other assessments that may be useful in diagnosis.
I’m really glad that the researchers are reviewing these criteria. It’s important to begin to think about the continuum of Alzheimer’s disease and also to incorporate the changing knowledge base about Alzheimer’s into the criteria. By doing so, we’ll both have a better handle about just who it’s impacting as well as evidence to support the need for additional research funding.
Published On: July 26, 2010