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Dr. Gary Small, author of The Mind Health Report newsletter, is a professor of psychiatry and aging and director of the UCLA Longevity Center at the Semel Institute for Neuroscience and Human Behavior. Dr. Small, one the nations top brain health experts, frequently appears on The Today Show, Good Morning America, and The Dr. Oz Show. He is co-author with his wife Gigi Vorgan of many popular books, including The New York Times best-seller, The Memory Bible, and The Alzheimer’s Prevention Program.

Let's face it — without a decent mind, you have no quality of life. With Dr. Gary Small's Mind Health Report, you'll gain greater health, happiness, and fulfillment in your relationships, personal life, work life or retirement, and more. Dr. Small fills every issue with the latest advancements in brain research from the far-reaching frontiers of neuroscience and psychiatry. You'll not only read about breakthrough techniques for rejuvenating your brain health, but also see actual case studies from Dr. Small, one of the nation's leading brain and aging experts and director of the UCLA Longevity Center.

Each month, you'll embark on a new journey into the world of your brain. You'll discover the latest on topics such as Alzheimer's disease and memory loss, anxiety and depression, diet advice for a healthy brain, natural supplements and drugs that aid mental functioning and lessen pain and fatigue, and much more.

Tags: aging | Alzheimers | amyloid | PET scan

Predicting and Managing Cognitive Decline

By
Friday, 27 December 2019 01:33 PM Current | Bio | Archive

Being able to accurately predict Alzheimer’s onset and progression is valuable for successful treatment, and research on early diagnosis and risk factors is making valuable progress.

For instance, scientists reported that people with hearing loss have three times higher risk for mild cognitive impairment than those with normal hearing. Mild cognitive impairment is a form of cognitive decline that is more severe than the common minor memory slips that everyone experiences with normal aging.

Most patients with mild cognitive impairment have a 10 percent risk of developing dementia within a year.

Another study showed that following nonelective hospitalizations, older adults experienced a 60 percent faster rate of cognitive decline. The researchers concluded that these results have implications for medical decision-making and care of older adults.

Other researchers reported on how PET scans can impact patient management. The ongoing Imaging Dementia — Evidence for Amyloid Scanning (IDEAS) Study, is evaluating whether obtaining a PET scan has an effect on a patient’s clinical outcome.

These scans display levels of brain amyloid, one of the abnormal proteins that accumulate in Alzheimer’s disease.

Although the FDA has approved the use of these scans, they are not currently reimbursed by Medicare or private insurance because of a lack of data showing they can lead to practical clinical benefits for patients.

In an assessment of 4,000 older subjects who were Medicare beneficiaries, researchers evaluated whether obtaining a PET scan changed patient management — for instance, beginning to take anti- Alzheimer’s medication.

The subjects all had mild cognitive impairment (MCI) or atypical dementia (i.e., their clinical course was not typical for Alzheimer’s disease), which can be a very challenging diagnosis.

In 68 percent of the MCI patients, medical management was altered after the PET scan results; and in 66 percent of the patients with atypical dementia, management was changed.

These results suggest that amyloid PET scans alter patient management. A more important outcome would be to determine if use of the scans resulted in improved outcomes.

Another promising study involved a blood test to detect amyloid in the brain. Previous studies demonstrated a connection between Alzheimer’s disease and the accumulation of brain amyloid protein into plaques.

In fact, the presence of brain amyloid plaques is required for making a definite diagnosis of Alzheimer’s. Currently, the only way to identify amyloid plaques in living patients is through a brain amyloid PET scan or examining cerebrospinal fluid from a lumbar puncture.

Less expensive and less invasive tests for amyloid accumulation are needed, and scientists from Washington University School of Medicine presented promising findings on a small study of a novel blood biomarker for amyloid.

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Being able to accurately predict Alzheimer’s onset and progression is valuable for successful treatment, and research on early diagnosis and risk factors is making valuable progress.
aging, Alzheimers, amyloid, PET scan
433
2019-33-27
Friday, 27 December 2019 01:33 PM
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