Last week I discussed my concerns about using biomarkers and brain scans to diagnose Alzheimer’s disease. This week Medscape (www.medscape .com) published an article that suggested that “misdiagnosis of Alzheimer’s disease [in about two thirds of participants] based on positron emission tomography scan readings appears to be a troubling problem that could get worse as more amyloid-specific tracers become available.” This is the first study to my knowledge to present objective evidence suggesting caution about the use of brain scans to make a diagnosis of Alzheimer’s disease. The unique thing about this study was that the scans were done on community dwelling participants (mean age of about 64 years). Studies used to make the case for the accuracy of scans have so far only used highly selected participants – a sampling bias that distorts results. The bottom line is that […]
Archive for April, 2012
I recently received a question about whether I stand by my concerns over the new criteria for diagnosing Alzheimer’s disease (original article from April 2011). The short answer is yes. Alzheimer’s disease presents in three broad ways. The first is an early stage where there are no obvious symptoms but changes are already occurring in the brain. This is the stage targeted by the new diagnostic criteria. The idea is that the failure of treatments in clinical trials to date is that we wait too long to start taking the drugs as the brain is too damaged to benefit. Successful treatment would delay or prevent progression to the next stage called Mild Cognitive Impairment where the problems are mild and there is no disability. Dementia is the third phase where changes are severe enough to cause loss of independence and […]
The question that I have been confronted by this week is how I know if memory slips are normal for my age or signs of memory loss. This question is central to boomers as they approach aging. As you age you expect to change. You can’t run as fast. You can’t burn the candle at both ends as long as you used to. On the other hand, you know more, you are better at solving problems. Your brain will shrink (starts at 20 so not a big deal). Is it any wonder that you have small changes in the efficiency of your memory – senior moments? Mental and memory skills show up in predictable ways as we age but we do not normally lose our memory. Normal aging is associated with slower thinking and inefficient multi-tasking – working memory. This […]
An interesting article was published in the British Medical Journal (April, 2012). Based on recent data from the Framingham Heart Study, survivors of malignant cancers have a lower risk of developing Alzheimer’s disease and those with Alzheimer’s disease have a lower risk of cancer. The Framingham Heart Study is a longitudinal study began in 1948 with over 5,000 participants ranging in age from 28-62. A second phase of the study enrolled children of the original participants beginning in 1971. A subset of these groups (who were not demented) was followed for 10 years to provide the data for this study. The cancer survivors had 33% less risk of developing Alzheimer’s disease than comparison subjects who never had cancer. Interestingly, survivors of smoking related cancers were less likely to develop Alzheimer’s disease than survivors of nonsmoking related cancers – however, they […]
Last week, I discussed the latest on intranasal insulin and Alzheimer’s disease. In mid February, I mentioned in passing that I was asked about coconut oil as a treatment for Alzheimer’s disease. Since then I have been besieged by questions about coconut oil. Bizarrely, the two articles converge. Let me try to provide a reasoned response to whether to try coconut oil as a treatment for neurological disease. The idea of using coconut oil to treat Alzheimer’s disease gained popular attention through Alzheimer’s Disease: What if There Was a Cure: The Story of Ketones a recent book written by Dr. Mary Newport. The book is an extended case study of Dr. Newport’s husband. She was frustrated with current treatments and theorized that the problem behind Alzheimer’s disease was that brain cells were starved for glucose. This is the same mechanism […]
