DIAGNOSIS: Alzheimer’s or Dementia, or Whatever?

With the escalating numbers of people classified as having Alzheimer’s Disease (AD) we are faced with a national epidemic in the making. Currently the Baby Boom is becoming the Senior Stampede. More folks are reaching age 65 than ever before. They are all at the age of higher risk of developing some form of Dementia.

This is at a level of public concern. It is a matter of public concern only to the extent it is understood. Soon it will be better understood as it becomes a scare and then will fall into a national panic. The numbers having this disease; the cost of having it; the inadequate care resources that now exist, all of this will focalize forcing the recognition of the calamity it will become.

For twenty years massive research has been conducted to try and find a cure. To date the research has not gotten anywhere close to a magic pill or other form of cure or containment. It is not even understood by researchers or by anyone else what the cause of Dementia is, particularly in the area of AD. AD is approached as a specific disease in both the research and the health care community. Dementia is seen as a classification of many diseases of which one is AD.

The Crisis Point will be produced by the numbers reaching seniors age, exacerbated by the population bulge now turning 65 and statistically lasting for the next 18 years; the longer life span being experienced in current years and the risk factor for all of an age greater than 65; this will bring about a Critical Mass that will produce a chain reaction equivalent of an Atomic Bomb reaching detonation. This obviously has the capacity of causing us to all fall into a National Bankruptcy.

The occurrence of this bankruptcy will change the nation inalterably should the nation be able to survive such a breakdown.

Can we do nothing to avert this tragedy?

Under the current makeup of Dementia and AD Support, Financial Interests, Inadequate infrastructure and the confiscatory cost of this, the catastrophe is unavoidable!

I have posted to articles I find relevant. They are:

·       Half of Alzheimer's cases misdiagnosed

·       Low Rate of MCI Progression to Dementia in the Community

Click on either to go to my Archive to read.

These articles reflect the differing views and the misconceptions that exist about AD and Dementia. Mild Cognitive Impairment (MCI) a term given low grade early stage dementia by the Mayo Clinic has caught on in the professional communities and now even is reflected in the forthcoming definitions being proposed in the Diagnostic and Statistical Manual of Mental Disorders (DSM V) revision that is in process.

The interesting nuance prompting this change is that any finding of mental impairment caused by injury to the organic brain, unless able to be diagnosed specifically as a kind of Dementia other than AD, has fallen into the classification AD. There was no other place to fit it in.  

The significance of the articles posted, now that the new description has been in use, the findings of AD are reducing where such a diagnosis is unwarranted. This is having a negligible effect on the ultimate numbers increase: it is important for a whole variety of other reasons.

Without having to bear the stigma of AD initially on an early diagnosis of impairment, this encourages and makes an early diagnosis far more acceptable. Early diagnosis allows for greater treatment, care, medicine and programs to keep these folks in the early stage longer. This both increase quality of life for those with “some” kind of impairment, it also saves their families and nation the cost of care.

This alone reduces the numbers needing care. The first article Half of Alzheimer's cases misdiagnosed speaks for itself. It is noted in this article:

Patients and their families can nevertheless benefit from an early and accurate diagnosis. Ruling out other forms of dementia may help relatives plan for future care and determine their own risk for Alzheimer’s, for instance.

 Accurately diagnosing Alzheimer’s is even more critical for research on potential treatments. Without knowing precisely who has Alzheimer’s, pharmaceutical companies that have been developing new drugs “are not going to be able to see a true assessment of how effective their drug is,”

 From the foregoing only one conclusion can be drawn. That is the field is changing. It is moving away from an automatic classification of AD, avoids non-action because of the personal stigma a diagnosis of AD produces, and allows the impairment to find its own appropriate niche.

This is a start and a good start in making the changes we need to survive the occurrence of calamity that will result from no action.

There is of course more and difficult action sorely needed. We need to educate everyone about the difference of Dementia, about AD not always able to be discerned while in the early stage, but a more generalized Dementia is able to be diagnosed and dealt with.

This means stepping away from the severely damaging stereotype AD has become.

We need to create an entirely new paradigm for the treatment and care of all Dementia.

We need to attack the cost of care head on.

Finally we need to take a real look at AD, recognize it as no more than a general category under its more general parent category Dementia. If we are to research for a cure we need to determine what mechanisms of damage we are able to define, what common pathologies exist between them and what it is the needs curing to eradicate the many different forms of this disease.

I will follow with more on the foregoing in subsequent posts. For now I point to the foregoing confusion in the field to exemplify the need to drop AD as a knee jerk finding, limiting its diagnosis to when it in fact can be identified, which is rarely in the early stage and get more on point in protecting us from the ravages that are building, much of which is aggravated by muddle in the way we are now handling it.