Alzheimer’s patients fare better if diagnosed early

Forget me not. The impact of Alzheimer’s disease continues to grow. Fortunately, a recent Medicare-sponsored study conducted at UCLA offers some promise of earlier detection and better outcomes for Alzheimer’s patients. Dr. Daniel H. Silverman, the lead investigator of the study, a clinical professor and the head of the Neuronuclear Imaging Section of the Ahmanson Translational Imaging Division at UCLA, proposes that Alzheimer’s patients who are offered a FDG-PET scan earlier in their diagnosis fare better than patients who aren’t offered a scan.

The study is unique in the sense that it is the first Medicare-approved trial in which the value of performing FDG-PET scans is assessed on patients diagnosed with Alzheimer’s.

“This is the first time anybody has ever done a clinical trial with a level of rigor on the evaluation of brain imaging for Alzheimer patients,” Dr. Silverman said.

In the blind study, the FDG-PET scan — a brain imaging tool that evaluates brain function region by region — was performed on all of the participants, but the interpretation of the scan results were randomized. In one group, the results of the brain scans were released immediately to physicians, and in the other, such information was withheld for two years. During the course of the two years, participants were assessed on their health and cognitive abilities every six months.

“Parts of the brain that are more active take up more glucose and more FDG … and if the brain is affected by Alzheimer’s it shows how it is decreased by the disease,” Dr. Silverman said, when discussing the value of an FDG-PET scan.

Evidently, aside from an autopsy, it is the single most effective way of determining whether or not someone has been affected by the disease.

“If someone has a normal pattern of FDG, there is a 95 percent chance that they don’t have Alzheimer’s disease,” Dr. Silverman said.

Thus, early signs of Alzheimer’s can be detected through the use of the scan.

The control group whose doctors were provided with the brain scan results saw the warning signs of Alzheimer’s and prescribed their patients with proper medication within the first six months of the study. However, the group whose doctors were not given the brain scan results immediately did not prescribe their patients with medication within the first six months. The prescription of medication by the end of the first year was also very slim.

Therefore, the results of the study indicate that when physicians are provided with as much information about a patient’s brain function, the more likely they are to prescribe an appropriate medicinal regimen at an earlier stage of diagnosis.

Although the results of the study are based on 63 participants out of the 710 approved, research is one medium that provides intervention to patients with Alzheimer’s, but sometimes isn’t fast enough to improve lives.

However, intervention at both the individualistic and the assisted-living levels are not to be discounted. According to Bruce R. Reed, a professor of neurology and the associate director of the UC Davis Alzheimer’s Disease Research Center, non-drug interventions are just as important.

“Supervision, companionship, social stimulation, activities at an appropriate level, providing for good nutrition, medical care and safety in daily activities – these are things that are extremely important,” Reed said in an email interview.

Patients of Alzheimer’s tend to do poorly on their own, regardless of the severity of the disease.

It is important to note that Alzheimer’s is a very complicated disease, involving both genetic and environmental influences. According to Laurel Beckett, a research specialist and biostatistician also at the UC Davis Alzheimer’s Disease Research Center, Alzheimer’s has many modifiable risk factors.

“Vascular damage to your brain … seems to increase the risk of Alzheimer’s or brings on the damage and symptoms earlier. We can actually prevent or treat a lot of the risk factors for vascular damage, through: smoking, hypertension and type 2 diabetes,” Beckett said.

The study is still in progress, however. In the meantime,  individualistic interventions can be made, such as modifying poor behaviors (for example, quitting smoking) and seeking continuous support from caretakers.

JASBIR KAUR can be reached at science@theaggie.org.

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