Why Early Detection, Diagnosis and Treatment Makes a Real Difference in the Fight Against Alzheimer’s Disease

When dealing with a degenerative condition that currently has no cure, there’s an understandable impulse to feel as if there’s no point in aggressively identifying Alzheimer’s disease early. But early diagnosis and treatment can have a seriously beneficial impact for patients and families and has strong implications for future treatment strategies.

The importance of a specific diagnosis

In the 21^st century, it’s still a fact that two thirds or more of individuals with dementing illnesses never receive a specific diagnosis. Patients in this category may be told that they have dementia, or they may be told that they have memory loss or mild cognitive impairment, but their specific disease state is never identified. And if a diagnosis comes, it may be years after the point when it could have been properly identified.

Here’s why that matters:

If you take a group of people with mild cognitive impairment and measure their spinal fluid proteins, research indicates that those with a pattern indicative of Alzheimer’s disease will have an almost 100% probability of progressing from mild cognitive impairment to a stage of mild dementia within five years. By comparison, individuals within that group that have a normal spinal fluid profile will have a less than ten percent probability of progression to mild Alzheimer’s disease.

What does that mean for patients and families? For those with a normal profile, it means that anxiety over the possibility of an Alzheimer’s diagnosis can be reduced, while taking the next step to determining the true root cause of the problem. For patients that are showing strong signs of developing Alzheimer’s disease, it means more time to plan for the road ahead, both in developing a plan for care and a plan to make the most of the remaining moments of their lives.

The relationship between early diagnosis and medication efficacy

By using biomarkers to identify dementia patients while they are still experiencing mild symptoms, the appropriate medication and care plan can be targeted to attack this stage of the disease. While still under development, Anti-Amyloid medication is showing promise in an ongoing trial  in altering the cognitive symptomology of patients with pet scans showing an Alzheimer’s disease profile, but not yet actively showing symptoms of the disease. Other research is showing that choline esterase inhibiting drugs are having an impact on Alzheimer’s symptoms as well as less common conditions such as Lewy Body Dementia. While not yet definitive, we should know in the next few years whether prevention therapeutics is a viable strategy in preventing or at least slowing down the rate of decline in Alzheimer’s disease patients.

But all of this promise comes with a catch: An early diagnosis is potentially critical to the success or failure of these new medications. These medications are not reversing pre-existing damage, but mitigating future damage. That means they are not alleviating symptoms that are already manifesting, but could be effective if treatment begins before these symptoms appear. In the case of Alzheimer’s disease, treatment delayed could in fact be treatment denied.

And not just an early diagnosis, but an accurate diagnosis is critical to the targeting of the right therapy to the right condition, even though the symptoms may all be broadly categorized as “dementia” initially. Take the example of choline esterase inhibitors. While possibly effective in treating Alzheimer’s disease or Lewy Body Dementia, there is evidence that shows these drugs could negatively impact patients suffering from Frontotemporal Diaspora and actually make their condition worse.

Early Alzheimer’s diagnosis can mean extending a lease on life

For the sake of argument, let’s assume that new medications are developed that can slow Alzheimer’s progression in patients with mid- or late-stage disease. Which do you think will be more meaningful for patients? Early treatment that preserves full or near-full cognitive performance for an extended period of time, or mid-to-late stage treatment that preserves the current state of an already debilitating condition?

Early screening, diagnosis and treatment could mean months or years where a patient can be fully engaged and present with their family, making new memories while preserving the old ones as long as possible. It means more time to get finances in order, make decisions on care and end-of-life planning, even more time to keep working at a business that provides personal fulfillment instead of a quick retirement—or maybe it’s the opportunity to stop putting off a trip that a patient has spent years dreaming about.

How you can catch a cognitive condition early

If an early diagnosis and treatment plan is essential in the fight against Alzheimer’s disease and other cognitive conditions, how can you work to ensure this outcome? You can start with regular cognitive screening as the first step and a step that you should be recommending for any patient over 65 . An effective cognitive screening for many types of dementia can be found in the Annual Wellness Visit. This Medicare-covered annual screening helps alleviate the anxiety around discussing a patient’s cognitive condition, as it can be suggested along with a range of other AWV screens for breast cancer, diabetes and other conditions. In short, it can become part of your patient’s annual routine instead of something to be stigmatized and feared.

If you suspect that cognitive issues may be present in a patient, the next step is to refer that patient to Georgia Memory Net. This organization is supported by the Georgia Department of Human Services’ Georgia Alzheimer’s Project, along with partners in Georgia academic institutions, community organizations, professional associations, and the State Aging and Disabilities Resource Connection Network.

Georgia Memory Net works to improve screening and care of Georgians with memory loss and other cognitive impairments linked to Alzheimer’s and related dementias. This care is provided by supporting patients through their primary care physician (PCP) via regional Memory Assessment Clinics (MACs). These MACs improve patient access to early and accurate diagnosis of Alzheimer’s disease and related disorders and improve long-term care and outcomes for patients and care partners.

At these centers, trained clinicians perform diagnostic assessment and care planning that helps a patient, their family and the patient’s PCP to develop a plan for managing whatever condition a patient is facing. The most important part is that no one will face it alone. The MACs will communicate diagnosis and treatment recommendations back to the patient’s PCP, so the provider is better prepared to treat a patient’s memory issues and cognitive decline. It effectively completes the circle, so that a patient’s condition is identified and treated as early as possible, and that is the key to making a real difference in their quality of life in the years ahead.