Nov 30, 2011

Is it Alzheimer's disease or another dementia?

New research finds a marker used to detect plaque in the brain may help doctors make a more accurate diagnosis between two common types of dementia.

By Bob DeMarco
Alzheimer's Reading Room

Bob DeMarco
To say I am annoyed right now would be putting it mildly.

Today, I received a call from someone I knew from my Wall Street days. The connection occurred because his elderly mother lives near us in Delray Beach, Florida. He found me from a very good doctor who knows me.

About half way through our conversation I learned his mother had not yet been officially diagnosed. It turns out his mother was not diagnosed by her personal care physician, nor had she been referred to a memory specialist for the necessary battery of tests needed to rule in, or rule out, a diagnosis of dementia.


The story worsened when he told me the name of her PCP, one of the doctors I had fired while trying to get a diagnosis for Dotty. 8 Years ago this doctor told me my mother was getting old.

I had already explained to him that my mother had a radical change in her behavior (meanness), was having trouble with her bills, and most importantly, she was scrapping her feet on the ground when she walked. This is a scrapping sound that I will never forget. I had to listen to the sound for years. Daily in the morning when my mother woke up and started walking on tile. Amazingly, through the use of the gym, and the stand up sit down exercise her feet rarely make that sound these days. Thanks goodness. I didn't like it.

My friend mother needs a full blown diagnosis by a neurologist or geriatric specialist. I can say, I am missing our now deceased and wonderful Dr Chiriboga. I could have solved my friends problem quickly and efficiently. That might not be the case now.

My friends mother did have a memory evaluation that does indicate possible dementia, Alzheimer's. Hopefully he will take the necessary steps to get the the necessary battery of tests to rule in or rule out dementia. In the meantime, I have a good understanding of what he might be facing in the days ahead. His mother is the same age as Dotty was when I came on to the scene.

Sadly, my experience today made me sad. 8 long years and not much has changed.

I am getting impatient.

The research described below is important.

Also see, Is it really Alzheimer's Disease or Something Else?

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Is it Alzheimer's disease or another dementia? Marker may give more accurate diagnosis

New research finds a marker used to detect plaque in the brain may help doctors make a more accurate diagnosis between two common types of dementia – Alzheimer's disease and frontotemporal lobar degeneration (FTLD). The study is published in the November 30, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"These two types of dementia share similar symptoms, so telling the two apart while a person is living is a real challenge, but important so doctors can determine the best form of treatment," said study author Gil D. Rabinovici, MD, of the University of California San Francisco Memory and Aging Center and a member of the American Academy of Neurology.

For the study, 107 people with early onset Alzheimer's disease or FTLD underwent a brain PET scan using a PIB marker, which detects amyloid or plaque in the brain that is the hallmark of Alzheimer's disease but not related to FTLD. The participants underwent another PET scan using a FDG marker, which detects changes in the brain's metabolism and is currently used to help differentiate between the two types of dementia.

The study found the PIB PET scan performed at least as well as the FDG PET scan in differentiating between Alzheimer's disease and FTLD, but had higher sensitivity and better accuracy and precision with its qualitative readings. The study found PIB had a sensitivity of 89.5 percent compared to 77.5 percent for FDG.

"While widespread use of PIB PET scans isn't available at this time, similar amyloid markers are being developed for clinical use, and these findings support a role for amyloid imaging in correctly diagnosing Alzheimer's disease versus FTLD," said Rabinovici.
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The study was conducted at the University of California (UC) San Francisco, UC Berkeley and Lawrence Berkeley National Laboratory, and supported by the National Institute on Aging, the California Department of Health Services, the Alzheimer's Association, John Douglas French Alzheimer's Foundation and the Consortium for Frontotemporal Dementia Research.

The American Academy of Neurology, an association of 24,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease and multiple sclerosis.

For more information about the American Academy of Neurology, visit http://www.aan.com.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,101 articles with more than 452,100 links on the Internet. Bob lives in Delray Beach, FL.


Original content Bob DeMarco, the Alzheimer's Reading Room