In my last post, I reviewed Alzheimer’s Care with Dignity by Frank Fuerst. It’s a book that I believe should be at your fingertips. In this post and others to follow, I want to highlight some of the chapters that were especially interesting and helpful. One of the most important members of your team is your doctor and in this post, I highlight how to choose a doctor for Alzheimer’s disease patients. However, Fuerst quotes the Alzheimer’s Association in the June 2006 report to Congress:

When a person under age 65 goes to a doctor with symptoms of dementia, the doctor may not even think of dementia as a possibility or may not know how to diagnose it. As a result, getting an accurate diagnosis can be a long, difficult, and frustrating process.

For Fuerst, it took almost three years and he states:

If one suspects early onset dementia, one should choose a doctor who can distinguish between depression, menopause, and dementia. A neuro-psychiatrist may be more likely to recommend tests that will give a more accurate diagnosis. The best choice for most people is a doctor whom other doctors highly recommend.

What makes an ideal doctor? A Mayo Clinic study suggests the following:

1. Confident
2. Empathetic
3. Humane
4. Personal
5. Forthright
6. Respectful
7. Thorough

Are there any other traits you could recommend?

Although there is still no conclusive test for the determination of Alzheimer’s disease (AD), there is hope and occasionally, new information. Last month, Science Daily reported that:

Elderly people exhibiting memory disturbances that do not affect their normal, daily life suffer from a condition called “mild cognitive impairment” (MCI). Some MCI patients go on to develop Alzheimer’s disease within a few years, whereas other cases remain stable, exhibiting only benign senile forgetfulness. It is crucial to develop simple, blood-based tests enabling early identification of these patients that will progress in order to begin therapy as soon as possible, potentially delaying the onset of dementia.

A group of investigators, led by Professor Massimo Tabaton of the University of Genoa, Italy, have data that sheds light on this issue. The results of their research are published in the October issue of the Journal of Alzheimer’s Disease.

The investigators report that the concentration in blood of amyloid beta “42,” the toxic molecule that is believed to be the main cause of Alzheimer’s disease, is, on average, higher in MCI cases that went on to develop Alzheimer’s disease approximately three years later. The values of amyloid beta in blood vary considerably among the patient groups examined (MCI that develop Alzheimer’s disease; MCI stable; normal subjects). “This variability is likely very important,” Dr. Tabaton noted and went on to add, “but means that this needs further work before we can use this test for a definitive diagnosis.” For example, the scientists are going to set up a test that picks up a variant of amyloid beta potentially more specific of the disease.

There’s progress, but we still have a long ways to go to find an effective test. A conclusive blood test would certainly be ideal. But even if we were to have a conclusive test, doctors still have very few effective treatments for Alzheimer’s disease. And still, as it has been for a long time, only an autopsy will reveal definitively whether or not a person truly had Alzheimer’s.