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Is There A Single Test For Diagnosing AD?
Posted: Thursday, April 26, 2012 8:20 PM
Joined: 12/6/2011
Posts: 3326

By: Liana Apostolova, MD, MSCR

test diagnosing Alzheimer's disease

Eli Lilly and Company announced on April 6, 2012, that the U.S. Food and Drug Administration had approved Amyvid, a radio ligand for use as a diagnostic tool for Alzheimer’s disease (AD). Amyvid is a chemical that binds to protein in the brains of AD patients. Neurologists and other specialists trained in dementia evaluation can use Amyvid to distinguish AD from other causes of dementia with very high diagnostic accuracy. While this is exciting news for physicians and patients, several questions remain unanswered and warrant careful consideration.

First, can this test become the sole test for diagnosing AD? The answer is a definitive “No.” Diagnosis of AD requires a detailed neurological and cognitive evaluation, a structural scan of the brain, and laboratory work-up that might reveal an alternative and treatable cause for the patient’s cognitive symptoms.

Next, who should receive this scan? Amyvid scans will aid physicians in diagnosing or ruling out dementia of the Alzheimer’s type, especially in complex and challenging cases of dementia. Amyvid may also be useful in mild cognitive impairment (MCI), where a positive scan could implicate AD as the cause of cognitive changes. In research studies, positive amyloid PET scans are associated with a three-fold increased risk for developing dementia among those with MCI. Still, Amyvid scans are not for everyone. Most experts agree that cognitively normal persons should not have these scans. Many cognitively normal persons above the age of 65 years would have a positive amyloid scan, despite having perfect memories. It remains unclear (and an area of intense study) what the implications are of a positive scan in cognitively normal persons. Until this is better understood, these scans should not be offered to those who have no cognitive symptoms.

Finally, after a cognitively impaired patient gets results of a positive amyloid scan; what then? Presently, there are no available treatments capable of slowing AD. A positive amyloid scan at present can only lend support to the diagnosis and assist the healthcare team in working with families to understand their situation and plan for the future. Once better therapies for AD become available, Amyvid scans may play an important role in directing treatment strategies. With many promising experimental drugs in clinical trials, hopefully this day will come soon.

Posted: Sunday, April 29, 2012 12:35 PM
Joined: 1/3/2012
Posts: 189

I have also read that a enhanced Pet Scan, like this new one developed to test for Alzheimer's is such a new technology that the doctor's have to be trained on how to read the Pet Scan.  How often are doctors trained on new technology, and how can you find the doctors that are? I did the trail at Stanford of this new diagnosis, procedure, two years ago. I am so happy the FDA aproved it.
Mimi S.
Posted: Tuesday, May 1, 2012 7:38 PM
Joined: 11/29/2011
Posts: 7027

I beg to disagree that nothing can be done! 


I truly believe that if one is diagnosed early and are faithfully following the Best Practices that here is a difference.


Several of us on these boards are living proof.


We would like to be involved in some kind of a study to actually prove it's more than happen chance.

Posted: Tuesday, May 1, 2012 11:09 PM
Joined: 12/5/2011
Posts: 795

I agree with Mimi.


There currently is no cure but there is drug treatment and best practices to be followed.  It has continued to keep me and many others in the early stages of EOAD for several years!!


There is always Hope when someone is diagnosed.


Peace and Hope,


Lane Simonian
Posted: Tuesday, May 1, 2012 11:40 PM
Joined: 12/12/2011
Posts: 5129

I agree with Lisa and Mimi.  Alzheimer's disease can be effectively treated with the right antioxidants--that is why a Mediterranean diet and exercise are so important.  At the risk of being misleading, I am going to copy a couple of sections from a recent article in the Alzheimer's Research Forum (a great site, but very technically--I usually just read it for the conclusions).   


It is worth bearing in mind that non-drug interventions, for example, exercise or diet, that are starting to be studied as interventions in AD possibly work, in part, through reducing oxidative stress.


This above quote and this next one comes from Douglas Galasko from U.C. San Diego.  I think he hits the key question here: 


The sobering responses from human clinical trials conducted to date suggest that new antioxidants with clear evidence of brain penetration would help us to further test our ability to intervene to reduce oxidative stress.  


This is why aromatherapy may be particularly effective because the antioxidant phenolic compounds in the essential oils can be directly inhaled into the brain.  If you combine this with exercise and all the polyphenols in a Mediterranean diet it may provide the best opportunity not only to stop the progression of Alzheimer's disease but to partially reverse it.


Posted: Thursday, May 3, 2012 1:19 PM
Joined: 1/3/2012
Posts: 189

I also disagree, with the statrment " Presently, there are no available treatments capable of slowing AD. " There are drugs taht slow the stages of AD along with a proper diat . But the problem was a test that can detect AD early enough to go on the AD drugs in the first place. The new Pet Scan is a improvment on the older one that used now,  that as good as a MRI scan.  When insurence aproved, and that takes time, the new pet scan will replace the MCI as part of the tests neeeded. More people will find out thay have AD, and earlyer ?  How will this effect local ALZ ASSN chapters, time will also tell.