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The dreaded brain disease, Alzheimer’s, is considered difficult to diagnose. For one thing, it comes on gradually in most cases and initially has no physical symptoms like pain or trouble moving around. Doctors usually first hear that a person has some problems with short term memory. Not much happens until that gets worse. Then, they rely on what the patient says, sometimes what family says, and referral to a neurologist for further examination. They don’t make a diagnosis without more data in most cases. If memory problems persist, they can reach a conclusion that it’s Alzheimer’s or other dementia by process of elimination.
The Cost of Diagnosis
There is currently no absolutely certain way to tell if a person has the disease until a post-mortem brain exam is done. Prior to that, a physician can order a PET scan (positive emission tomography), which is not likely to be covered by Medicare. That can cost thousands of dollars. The M.D. can also refer to a neurologist for more examination, mainly to rule out other causes and do some basic screening for memory problems. That does not always lead to a clear diagnosis either.
Sometimes, the physician will refer the person to a neuropsychologist for standardized testing, which can result in a diagnosis. The testing protocol involves talking, paper and pencil items, drawing figures, and asking specific kinds of questions the test subject must answer. The results can show areas of cognitive difficulty that these tests measure. Again, the cost of the visit to the professional licensed to do this testing can run the patient thousands of dollars. Currently there is no widely used blood test to help diagnose the disease. But things are changing.
New Blood Test
The Washington Post reports that there is now a blood test that can offer good accuracy in the diagnosis. The article reveals that the blood test is 90% accurate, as compared with other ways to diagnose. Quoting from the piece they tell us:
“Compare that with dementia specialists who successfully identified Alzheimer’s 73 percent of the time, while primary care doctors did so with a 61 percent rate, according to the study of 1,213 patients in Sweden that was published Sunday on JAMA, the journal published by the American Medical Association, and presented at the Alzheimer’s Association International Conference on the same day in Philadelphia.”
The blood test works by measuring certain kinds of protein that are biomarkers for Alzheimer’s disease. Those specific kinds of protein in the blood reflect protein deposits in the brain that are hallmarks of the disease.
A Blood Test Can Be Exceptionally Useful
About 6 million people are now diagnosed with Alzheimer’s disease in the U.S. alone. That number is projected to increase rapidly over the next decades with an anticipated 14 million to be diagnosed by 2060. What we observe in working with families at AgingParents.com is that dementia related problems are the most common reason people seek our professional advice and guidance. And we see many families of elders who have all the typical Alzheimer’s symptoms but have not been diagnosed yet by any doctor. We also observe that misdiagnosis is common. Doctors seem to get the diagnosis wrong as often as they get it right. That mirrors what the article from the Washington Post tells us too.
Implications For Families
Early diagnosis of Alzheimer’s disease or related dementia can be a great help to families, who must plan for the person’s care that will eventually be needed. The cost can be staggering. It also has very important legal implications. For example, if the person in a family in charge of finances is diagnosed, it is imperative that they have an end date for managing money. The loss of financial judgment is inevitable with Alzheimer’s disease. Having an early diagnosis can help protect the family’s or individual’s financial safety. We do not know when such a blood test will be widely available and covered by Medicare. But when it is, anyone with memory loss that interferes with daily life should get it. If this blood test is ultimately accepted by the medical community, it could be a tremendous help in protecting the vulnerable folks, usually elders, who are at risk for the damage that Alzheimer’s does. In the meantime, we must still rely on the slower, more expensive and less reliable means of diagnosis that exist right now.