Early Alzheimer’s Diagnosis Could Help Slow Disease Progression

Just like every other body part, the brain tends to slow down as we age. This can cause temporary lapses in memory, which is why we sometimes forget where we left our keys or struggle to remember the name of a book or movie. There are instances, however, when forgetfulness signals more than a simple sign of aging. About 5 million Americans, including roughly one in 10 people ages 65 or older, have symptoms of Alzheimer’s disease (AD). Even larger numbers have a more subtle precursor called mild cognitive impairment (MCI) or mild dementia due to AD. Although there is no cure, there are U.S. Food & Drug Administration-approved drugs— ecanemab (Leqembi) and aducanumab (Aduhelm)—that can slow development of symptoms. Early diagnosis—at the MCI stage—leads to early treatment, and early treatment slows progression.

If evaluations confirm MCI, the patient will be referred for diagnostic biomarker testing and brain imaging. If tests and imaging show beta-amyloid accumulation (AD is characterized by abnormal clumping of beta-amyloid and tau proteins in the brain) the patient will return to the specialist to plan treatment.

Don’t Delay Diagnosis

All too often, people are reluctant to see a doctor and tend to wait until the condition has a noticeable impact on their lives, according to a report released by the Alzheimer’s Association. The report includes findings from a survey of people with subjective cognitive decline, which is the clinical term for self-perceived worsening of, or more frequent difficulties with, thinking or memory. According to the survey, only 40% of participants said they would talk to their doctor right away if experiencing symptoms of MCI. However, 70% of those surveyed said they would want to know as early as possible if they have Alzheimer’s disease if knowing could offer a pathway for earlier treatment.

Those who said they would not share their concerns with their doctor attributed this to things such as limited vocabulary, fear of an incorrect diagnosis, and worries about receiving unnecessary treatment. However, it is important for people to bring these concerns to their physicians, because the survey found that physicians do not take the initiative to talk with patients about this topic. Nearly all surveyed physicians said they do not mention memory or cognition issues unless someone broaches the subject or requests an assessment.

Thorough Evaluation

Once your physician is made aware of your cognitive concerns, the physician may administer some tests. If the test results suggest MCI, the physician will make a referral to a memory disorders specialist, who will conduct further evaluations. “There are many reasons why people have problems with their memory, and not all memory changes are permanent or progressive,” says Lisa D. Ravdin, PhD, ABPP, associate professor and director of the Weill Cornell Medicine Neuropsychology Service. “For those with real memory disorders, there are treatments available. A memory disorders specialist can evaluate potential contributors to memory issues, such as sleep difficulties, anxiety or mood issues, and other disorders that impact attention and concentration,” says Dr. Ravdin.

If you think your memory or thinking abilities fall outside of the bounds of the aging process, bring those concerns to your doctor. “He or she can evaluate your physical health and do some laboratory testing for things like vitamin deficiencies, metabolic issues, or infections, and they can review medications to see if that may be playing a role. Your physician can make lifestyle recommendations to support cognitive health, and if necessary, suggest a more in-depth evaluation by a memory disorders specialist,” says Dr. Ravdin.

“Now that there are medications available that delay progression of memory problems, you would want to begin using those medications—if they are needed—before the memory impairment is too severe.”

Diagnosis is key, she says, because not all causes of forgetfulness are progressive memory disorders. “Early intervention is associated with improved quality of life, and both patients and their families can get the support and information they need.”

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