Dec 22, 2011

Identifying Alzheimer's and Cognitive Decline Risks Before Its Too Late

The ability to identify people who are not showing memory problems and other symptoms but may be at a higher risk for cognitive decline is a very important step toward developing new ways for doctors to detect Alzheimer's disease. -- Susan Resnick, National Institute of Aging

By Bob DeMarco
Alzheimer's Reading Room

Bob DeMarco
I am a strong advocate for the early detection of Alzheimer's disease. In the future, test will be available that will let you know if you are predisposed to Alzheimer's long before memory loss sets in.

I know some say, why would you want to know if you can't do anything about it?

I cannot tell you how many times I thought, and wished, that I could have talked to Dotty while she was still able to comprehend what I was saying. Before she lost her ability to reason.

The single most important thing I would have done is to reassure Dotty that no matter "what happened" I would be taking good care of her; and that, she would get to stay "at home" as long as it was medically possible.

I would have reassured Dotty over and over and over, with the goal of embedding this in her brain.

In the future, families will have the opportunity to make plans, to address financial and care issues. They will get the opportunity to make choices.

We did not have this opportunity with Dotty. I know for certain that anyone out there that is like me will want this opportunity. If for no other reason, so that they can "set their house in order" while it can still be done.

I did get the chance to tell Dotty I would take care of her. If I knew there was a chance that she could suffer from Alzheimer's disease I would have done it another 1,000 times.

As many times as it would take to make sure that she had "no doubts" -- ever.

The research study described below gives me hope.

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Size Matters: Measuring Brain Thickness Identifies Those at High Risk for Cognitive Decline, Penn Study Shows

A new measurement tool can identify cognitively normal adults who are at high risk for cognitive decline, according to a new study by collaborators at the Perelman School of Medicine at the University of Pennsylvania and Harvard Medical School.

The study is published in the December 21, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The team looked at measurements of cortical thickness in the brain, an indicator of brain atrophy usually due to loss of neurons or their connections. Using MRI scans, they measured cortical thickness in several brain regions that had previously been shown to be associated with the injury due to early Alzheimer’s disease.

In this case, these measurements were obtained in cognitively normal adults who were followed over time, allowing the researchers to assess whether cortical thinning in these regions tracked with their cognitive abilities.

Researchers found that individuals at high risk for preclinical Alzheimer’s Disease, based on reduced cortical thickness in these regions, were more likely to experience cognitive decline, which developed in 21 percent of cases, compared with 7 percent of average risk cases, and 0 percent of low risk cases.

David Wolk
"The ability to determine who is at greatest risk for Alzheimer’s Disease among cognitively normal older adults may allow us to better focus preventative interventions on these patients prior to their developing symptoms," said study co-author David Wolk, MD, Assistant Professor of Neurology and Assistant Director of the Penn Memory Center. "Further research is needed to explore whether this measure alone, or in combination with other diagnostic tools, bests predicts future development of Alzheimer’s Disease."

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4 billion enterprise.

More Insight and Advice for Caregivers

Original content Bob DeMarco, the Alzheimer's Reading Room