5 things I wish everyone knew about Alzheimer's

by Dennis Fortier, President Medical Care Corporation

There is much needless confusion about certain aspects of the Alzheimer's field. In fact, this blog exists almost solely to help reduce that confusion.

Many bloggers, and some sloppy journalists, compound the problem with their inaccurate daily descriptions and ambiguous word choices. Here are 5 things I wish they would all get straight:

1. Alzheimer's is but one disease, albeit the most common, of many that can lead to dementia.

Parkinsons's disease, stroke, head injuries, and a host of other medical conditions can also lead to dementia. Alzheimer's is a progressive disease that seems to begin with an accumulation of amyloid protein in the brain, followed by subtle symptoms of memory loss, and eventually, enough brain damage to render a person demented.

2. The term "Dementia" does not refer to a disease.

Dementia is a term that describes a fairly advanced state of cognitive decline, when diminished brain health is so severe that it interferes with a person's life. How a person has arrived at that state of diminished brain health is a separate and distinct matter.

Importantly, when you hear about "early dementia", you are hearing about the earliest stages of a condition that is already quite severe. A little memory loss is a problem that should be evaluated, but it is not "dementia" until it becomes so severe that it interferes with daily living.

3. Early detection of Alzheimer's is not the same as "predicting" Alzheimer's disease.

In the first case, we would identify the pathology of AD and provide optimal treatment, prior to the massive brain damage that eventually causes dementia. Predicting risk, on the other hand, is still a very uncertain science with complex pros and cons. (So complex, in fact, that many bio-ethicists are currently able to earn a living discussing them.)

4. Having "no cure" for Alzheimer's is not the same as "having no treatment".

Controlling symptoms and slowing disease progression are both beneficial outcomes short of a cure. Because we don't understand the disease well, it has been difficulty to identify drugs that significantly alter the disease course. However, much of the perceived inability to treat the disease is driven by the fact that we identify AD much too late, and intervene only after major brain damage has occurred.

The negative perception of treatment is also driven by a narrow focus on drug efficacy, as opposed to the combined effect of a more robust treatment approach involving diet, exercise, and management of contributing conditions.

5. Very few diseases can be diagnosed with 100% certainty, Alzheimer's is not particularly unique in this regard.

By following published guidelines for a diagnostic work-up, physicians can accurately diagnose AD more than 90% of the time. This is well within the range of acceptable clinical certainty. The repeated mantra in the press, that an autopsy is required to diagnose AD with 100% certainty, may be true but is also nearly meaningless.

With more careful reporting on these 5 aspects of Alzheimer's disease and dementia, we could eliminate much unnecessary confusion which could help us approach solutions with more clarity and success. Please share this post with your online networks to help spread the message.