New Technologies Enable Early Detection of Dementia and Alzheimer’s Disease.
By Dr. Christopher Riedl
Few things are as valuable to us as our minds and memories.
A couple of years ago, a good friend of mine was diagnosed with Alzheimer’s at age 54. His two daughters were barely teenagers when they had to see their dad lose his license to drive and practice law, and soon after, lose grip on their lives entirely. It was just as devastating for them as it was for him.
Many of us have dealt with the pain of having a loved one with Alzheimer’s or dementia. Too many have had to watch a bright mind dim, have had tender memories forgotten, and have seen a loved one become a stranger.
These diseases are frightening and have historically been difficult to differentiate. But new advances in diagnosis and treatment are starting to make them less mysterious and potentially less devastating if treated early. These developments couldn’t have come at a better time.
Alzheimer’s and dementia are more pervasive than ever.
The World Health Organization reports that 55 million people are currently suffering from various forms of dementia, and nearly 10 million new cases are diagnosed every year. Dementia is the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally, according to the World Health Organization. It has physical, psychological, social, and economic impacts, not only for people living with dementia, but also for their caregivers, families, and society at large.
The problem is that Alzheimer’s is a notoriously misdiagnosed disease.
It often goes untreated for many years, years in which brain function could be saved, since effective therapies are now available.
For treatments to be successful, catching the disease as early as possible is key.
This is why it is important to take action as soon as there is suspicion of cognitive decline. Taking action means seeing a neurologist, psychiatrist, or even a family doctor familiar with diagnosing dementia. They will conduct the necessary cognitive tests, such as tests of memory, attention, counting, and language. They will also order blood, urine, and other standard medical tests that can help identify other possible causes of the problem. A psychiatric evaluation will be administered to determine if depression or another mental health condition is causing or contributing to a person's symptoms. But even with all this testing, coming to a final and firm diagnosis is often difficult.
In the past, a final diagnosis was only possible during post-mortem autopsies, where amyloid plaques were confirmed in the brain by pathology.
But recent improvements in molecular imaging have made it possible to get functional images from the brains of living persons. These scans are called PET/CT scans. PET stands for Positron Emission Tomography and is a rapidly developing technology where low doses of radiation attached to molecules of specific biological functions are used to depict information from the brain that, when used at a center with the right technology, can be shockingly accurate. These images can add that extra piece of information that is needed to start you on a treatment that can change the trajectory of the disease.
Two main types of PET/CT scans.
There are currently two main types of PET/CT scans for Alzheimer’s, both playing their own important role.
The first is called FDG PET/CT and looks at the brain’s sugar metabolism. This scan has been around for a while, and while the information that can be derived can be extremely informative, for many years, doctors had a hard time interpreting the changes at early stages when the changes were subtle.
The second type is the Amyloid PET/CT. This scan looks at the existence of amyloid plaques in the brain, accumulations of misfolded proteins that are a hallmark of Alzheimer’s disease and presumed to play a central role in the interference with memory and thinking.
With new tracers and software, we can now detect dementia-related changes up to a decade before any symptoms arise.
New computer software compares your scan with thousands of healthy brains, which can now help us identify even the subtlest changes and make the test much more sensitive. With these programs, we can often detect dementia-related changes up to a decade before any symptoms arise! It also allows for differentiation between Alzheimer’s and other causes of dementia. It is important to make sure your radiologist uses these computer programs.
The newest treatments against Alzheimer’s.
The newest treatments against Alzheimer’s target the buildup of these amyloid plaques and remove them from the brain. This is a game changer. But like all medical treatments, this approach is not free of risk. Which is why the FDA made it a requirement to prove the existence of amyloid plaques with a PET/CT before the treatment gets approved.
My core message.
If you or a loved one is concerned about dementia or Alzheimer's disease, don’t procrastinate. Get it checked out. The stress of not knowing is harmful to your health. Get a PET/CT scan to either alleviate your worry or help determine the proper treatment in time. Remember, early detection is the best treatment.
If this message finds anyone looking for more answers, feel free to call me at imagingwest directly at +1-914-592-0218.
Dr. Christopher Riedl
