Keeping in mind that there are no clear-cut boundaries that separate the stages of Alzheimer’s, we now move on to more obvious signs — Alzheimer’s Disease: Stage 4 Moderate Cognitive Decline. According to the Alzheimer’s Association, through a careful medical interview, the following deficiencies can be identified.

• Decreased knowledge of recent occasions or current events
• Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s
• Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances
• Reduced memory of personal history
• The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations

Going back to the couple in my last post, I mentioned that she took an extraordinary amount of time preparing instant coffee. I can only imagine that planning a dinner for guests would no longer be possible. In the case of him, he did not remember my stopping him to check on his shoes. In retrospect, I should’ve brought the other pair of shoes to him right away to see if it was his. However, since he insisted it was his shoes, I let it go. But had I brought him the other pair of shoes, I never would’ve had the opportunity to sit down and talk to him in his home. Everything happens for a reason.

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.