Today's blog comes from Mercè Boada, Founder and Medical Director of Fundació ACE, Institut Català de Neurociències Aplicades
How does somebody usually find out that they have Alzheimer’s disease?
It depends on the person’s level of symptom awareness, which usually correlates with cognitive impairment. In patients with mild cognitive impairment, the first alarm is the occurrence of difficulties in the performance of complex and key daily activities. In this setting, we inform the patient about the diagnosis and the risk of progression to Alzheimer’s disease (if there is no risk of suicide or high level of depression). Patients with mild dementia are frequently not aware of their symptoms and deficits, although they do have some moments of clarity, including important daily activities. In the case of patients with mild dementia, we inform them and as it is highly likely that they will forget the information, the presence of a caregiver is important.
Why is early – or even timely – diagnosis of Alzheimer’s disease so challenging for healthcare professionals?
It is difficult to diagnose Alzheimer’s disease in the early stages because the general population and healthcare professionals (GPs, PCPs, and general neurologists) believe that cognitive deficits are “normal” in the elderly. There are other reasons too, some people live alone and don´t have a partner who can identify their deficits, sometimes the patient or the caregiver don´t realise deficits are occurring until they are very obvious. In other cases, the patient doesn’t want to be diagnosed by fear of the disease, or the close relatives don’t want to hear the diagnosis because they fear seeing their loved one suffer.
High on the agenda globally is identifying ways to improve early diagnosis of Alzheimer’s disease and to change the current perception that is part of the normal aging process. Generally, GPs/PCPs do not consider memory loss relevant for clinical assessment, due to an enormous lack of education, information and training in cognitive assessments.
Today, there is no way to cure or prevent Alzheimer’s disease. What good is early diagnosis if there is no treatment?
Although there is no treatment yet, there are benefits to receiving an early diagnosis: 1) the patient and the relatives know the cause of the cognitive impairment, which prevents uncertainty and the need of going from one physician to another; 2) the patient can make decisions about her/his future regarding legal issues before the disease progresses and prevents her/him to understand complicated issues; 3) these patients can participate in medical research or in clinical trials investigating the disease.
What is the value of European cooperation in the field of R&D for Alzheimer’s disease?
Any cooperation on such an important social and healthcare issue has significant value because it makes it easier to find solutions and to exchange experiences. R&D programmes need to receive excellent funding to result in knowledge and patents.
Taking into account the social aspect of the disease, European cooperation would be a great opportunity to establish strategies focussed on increasing knowledge and awareness of this important issue through collaboration between health policymakers, stakeholders, national Alzheimer associations and academic institutions.