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Ten
Warning Signs of Alzheimer's Disease
PHILADELPHIA
(Reuters Health) - Early recognition and diagnosis of Alzheimer's
disease is becoming increasingly important given an ``explosion
of information'' of the memory-robbing disorder in recent years,
experts at the American Academy of Neurology announced here on
Monday at their annual meeting.
While once
considered to be a disease that could only be reliably diagnosed
by autopsy after death, the group said this is no longer true.
The group last issued treatment guidelines on Alzheimer's disease
in 1994.
``The main
message for physicians to take home is that Alzheimer's disease
can be reliably diagnosed,'' Dr. James C. Stevens, of the Indiana
University School of Medicine in Bloomington, told Reuters Health.
About 95%
of patients with Alzheimer's disease can be accurately diagnosed
with the disease while they're living, Stevens added. ``This is
important as treatments are becoming available that seem to impact
disease as far as cognitive function, standard of living and behavioral
function go.''
And while
the disease is incurable, there are treatment options. The group
issued a list of early warning signs of the disease, including:
-- memory
loss that affects job skills, -- difficulty performing familiar
tasks, -- language problems, -- getting lost, or being disoriented
as to time and place, -- poor judgment, -- problems with abstract
thinking, -- misplacing objects, -- changes in mood and behavior,
-- personality changes, -- loss of initiative.
To better
rule out other causes of memory loss or dementia, brain imaging,
whether it is computed tomography (CT) or magnetic resonance imaging
(MRI), is now recommended, according to the group. Genetic testing,
however, has not been found to be particularly useful and is not
recommended. Some genes have been found to increase the risk of
the disorder.
``Patients
and their caregivers are better prepared to deal with the disease
if diagnosis is made earlier than later,'' said Dr. Steven T.
DeKosky, of the University of Pittsburgh, at the American Academy
of Neurology's annual meeting. ``We believe public health issues
of early detection and diagnosis will help in the development
of more effective treatment.''
Drugs known
as cholinesterase inhibitors appear to be a promising way to delay
the progression of Alzheimer's disease, said Dr. Jeffrey L Cummings,
of the University of California at Los Angeles.
In addition,
the evidence is strong that antipsychotic medications are useful
in the treatment of Alzheimer's-related agitation and psychosis--a
loss of contact with reality. The evidence is ``fair'' that ``antidepressants
should be used for Alzheimer's disease patients with depressive
symptoms,'' Cummings added.
The guidelines
also highlight the finding that the use of music and exercise
therapy in later stages of the disease are effective in managing
behavior.
The guidelines
incorporate the new information that has come to light in recent
years, Stevens said. ``It says that patients who come into a doctor's
office complaining of mild cognitive impairment should no longer
to be dismissed and reassured that nothing is wrong. That patient
needs to be evaluated and followed.''
The multidisciplinary
panel of 21 experts that developed the guidelines examined more
than 1,000 studies. Their efforts have resulted in a list of 43
``action-oriented'' clinical recommendations.
``Our challenge
is to increase the public's knowledge, that losing one's memory
in old age is no longer just to be expected,'' DeKosky said. ``Alzheimer's
disease is clearly different from normal aging. People need no
longer accept that they will lose their thinking ability as they
grow older.''
Reference
Source 101
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