ASK DR. MINDY™
MINDY KIM-MILLER, MD, PhD
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My mother was finally diagnosed with Alzheimer’s disease after weeks of testing and seeing various doctors. It seemed like the doctors had to figure out what she didn’t have before they could figure out what she did have. Why is it so hard to diagnose Alzheimer’s disease? Is there hope of finding a better way to diagnose the disease?
–Sarah, 51, Austin
Diagnosing Alzheimer’s disease (AD) can be challenging, because many other diseases and medical conditions can cause similar symptoms. Your mother’s physician is doing the responsible thing by investigating all the possible causes of memory and behavior symptoms. AD is a diagnosis of exclusion, meaning that many other possible causes of dementia have to be excluded before the diagnosis of AD can be made with any certainty. At this time, the only way to make a diagnosis of AD with 100% certainty is by a brain biopsy, which is done after death if at all. There is a clear need for better ways to test for the disease, and many researchers have taken on this challenge.
An exciting area of research involves testing the blood for signs of the disease. Researchers are looking for abnormal levels of certain substances in the blood of people with AD or mild cognitive impairment (MCI) compared to people without cognitive problems. One of the difficulties with many forms of dementia is that by the time the symptoms are noted, the disease has already been damaging the brain for some time. These new tests would be useful in identifying people who are already developing the disease years before symptoms appear. One blood test being developed examines the levels of 18 different substances in the blood and appears to predict the development of AD in those with MCI with 90% accuracy. Early diagnosis would allow early intervention to try to delay the onset or progression of symptoms.
Blood tests are easier to do and, in some cases safer and more comfortable for the patient, than many other tests currently used in diagnosing AD, such as spinal fluid tests. A blood test would also make it easier to follow the progress of the disease and to conduct research. There may soon be diagnostic blood tests for AD and MCI.
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