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How do we detect Alzheimer’s Disease early?

What can we do we to detect Alzheimer's Disease in its earliest stages, before irreversible brain damage or mental decline occurs? Scientists are still doing research on ways to diagnose Alzheimer's Disease earlier. However, there are actually some tests that we can do to have a better chance at securing an earlier diagnosis of the disease.

With an earlier diagnosis, the doctors will be able to start treatment earlier, which means a better long-term prognosis and possibly better outcomes as time passes.

Currently, the diagnosis of Alzheimer's disease relies mainly on the signs and symptoms of Alzheimer's. However, by then, it is very likely that irreversible and severe brain damage has already occurred. Hence, some experts believe that identifying certain biomarkers might help us to identify those in the earliest stages of the disease.

Some examples of biomarkers for Alzheimer's Disease that are still under research include:

  • beta-amyloid levels
  • tau levels
  • changes in the brain that can be detected by imaging

Beta-amyloid and Tau levels can be detected through testing of one's cerebrospinal fluid (CSF), which can be obtained from a minimally invasive procedure called a spinal tap.

Imaging is also another way Alzheimer's disease can be detected earlier. There are 3 main brain-imaging technologies: Structural, Functional and Molecular imaging.

Structural imaging

People with the disease tend to experience a decrease in brain tissue as the disease progresses, since their brains tend to shrink in size over time. Thus, structural imaging through the use of CT or MRI scans can help to detect a shrinkage in specific brain regions like the hippocampus, which may point to early stages of the disease. Furthermore, scans can also show if the patient has experienced severe head trauma and/or strokes, which may increase the risk of getting the the disease.

A patient going through a CT scan machine

Functional imaging

Research has shown that people with the disease tend to have reduced brain cell activity in some regions of their brain. There may be a reduction in the amount of glucose (sugar) used by certain parts of the brain that are important in memory, solving problems and learning. Thus, an FDG-PET scan is another technique that can be used to diagnose the disease.

Molecular imaging

This technique uses PET scans to help detect certain biomarkers like proteins, which when detected in abnormal levels, can mean that the patient has Alzheimer's disease in its earliest stages. This imaging method is also one of the most widely researched areas for early diagnosis of the disease.

Spinal Tap to obtain CSF fluid

A spinal tap is a procedure carried out to obtain CSF fluid, which can be tested for the levels of biomarkers like Tau and Beta-amyloid, which form abnormal deposits in the brain that have a strong link to Alzheimer's disease. One other potential biomarker is neurofilament light - an increased levels of it has been found in patients with the disease.

Blood tests for biomarkers and genetic risk profiling are some other methods that can help to spot Alzheimer's early, but they are still in their early stages of development and may be used more widely in the future.

Diagram of a spinal tap procedure

A spinal tap is carried out by inserting a hollow needle into the lower back, whereby fluid is then removed for analysis.

What are some prevention measures for the disease?

There is still no exact cause of the disease, hence it is not possible to totally prevent the disease. However, research has shown that certain diseases, like cardiovascular disease, which can be prevented to some extent, can increase the risk of Alzheimer's disease.

You can do the following to reduce your risk of contracting the disease

  • stopping smoking
  • reduce your consumption of alcohol
  • eat a balanced and healthy diet
  • exercise for at least 150 minutes every week
  • control your blood pressure by doing regular checks
  • keep your blood sugar under control, especially if you have diabetes by taking your medication and controlling your diet

Various types of fruits and vegetables

Research has also shown that staying both physically and mentally active can help reduce your risk of getting the disease. You can:

  • read often
  • learn a foreign language
  • play a musical instrument
  • go out with your friends
  • play mentally-stimulating games like chess, mahjong or checkers
  • trying new activities

How is Alzheimer's treated?

Lifestyle Changes and Caregiver education

If you are a caregiver for someone with Alzheimer's, it is important that you try your best to help the patient to continue living an active and healthy life. People with the diseases may get irritated when once-easy tasks become challenging due to the worsening disease. Here are some practical tips that you can try to help make daily activities easier:

  • establish a daily routine
  • take your time and try not to rush as daily activities may become slower as time passes
  • involve the person actively (try to help them lead a more independent lifestyle and allow them to take care of themselves to the best of their ability)
  • provide choices so that they can lead a more active lifestyle
  • limit napping throughout the day to ensure that they can sleep well at night
  • reduce distractions like loud sounds from the television during activities that require focus such as mealtime or during conversations.
  • arrange for finances to be automatically paid

It is important to maintain a safe environment where the patient is living, as people with Alzheimer's tend to fall more easily and accidents may occur at any time. You should:

  • prevent falls by installing hand rails in slippery areas like the toilet and avoiding clutter like extension cords which can cause falls
  • install locks on cupboards which contain anything that could be dangerous like medicine, alcohol or toxic substances/items
  • keep lighters/matches out of reach to reduce the chances of a fire occurring
  • install alarm sensors

Above all, it is important to remain patient and calm when taking care of someone with Alzheimer's disease. As the disease progresses, it may become harder to maintain the same routine, and thus maintaining flexibility is also equally important.

What are some oral medications for Alzheimer's?

There are 2 broad categories of drugs used to treat Alzheimer's disease - namely Cholinesterase inhibitors and memantine.

Cholinesterase inhibitors help to preserve communication between cells by preserving a certain hormone (acetylcholine) that is reduced in people with the disease. Using this medication can help to improve the patient's mood, and reduce symptoms like agitation or anxiety. Some potential side effects include:

  • diarrhea
  • nausea
  • loss of appetite
  • sleep issues

Memantine also helps to improve brain cell communication and is sometimes used along with the first drug mentioned above. Side effects can include confusion and dizziness.

White pills

While patients may have certain behavioural symptoms from the disease like depression, anxiety, aggression or sleeplessness, most doctors try not to prescribe medicines to specifically treat these symptoms unless there is no better option. For instance, while anti-depression and sleep aid medication can help to improve symptoms like depression or inability to sleep, they can cause or worsen problems such as a greater risk of falls, confusion or dizziness.

Palliative Care

Alzheimer's disease can take a toll both on the patient and their caregivers. Sometimes, it can be very difficult and stressful for the caregiver as the disease progresses, and it may be then that they wish to consider other options such as palliative care.

Illustration of palliative medicine

Palliative care is specialised medical care for patients with serious illnesses. Placing a patient in such care can help to improve their quality of life, as well as that of their caregivers. The patient will also be in good hands, and will be taken care of a specially trained team of doctors, nurses, therapists, social workers and more.

The team can also provide the caregiver with emotional support and tips on how to avoid triggering certain behaviour symptoms of the disease, and provide an extra layer of support.

For more information or if you require a medical consultation, please contact My Healthcare Collective here.