Issues in Dementia Diagnosis, Research, and Lexicon (Alzforum – April 20, 2016)

A nice write-up was posted today to Alzforum on the recent Alzheimer’s Disease-Related Dementias (ADRD) summit at NIH. This year’s summit was focused on Lewy body, frontotemporal, vascular, and mixed dementias. Here are some interesting quotations from the write-up:

  • Because many dementia patients are unaware of their problem, they often don’t tell their doctors. “Families participate in that, too. It is human nature,” said David Knopman, Mayo Clinic, Rochester, Minnesota. This leads to significant under-diagnosis. “Primary care practices are also problematic: physicians don’t have time for a mental status exam or to talk to families, and they aren’t always familiar with all the various dementing illnesses,” Knopman said.
  • Treatable causes of dementia are quite common, [Neill Graff-Radford, Mayo Clinic, Jacksonville, Florida] said: sleep disorders, thiamine, copper, or other nutritional deficiencies, and certain medications, to name a few.
  • The diagnostic criteria for DLB and FTDs work well, and even when the dementia is progressive, symptoms can be controlled early on in some cases. For instance, medications can control sleep disorders, cognitive impairment, and motor problems of DLB, and treating hypertension may slow the progression of vascular dementia.
  • What’s more, an accurate diagnosis can direct people toward clinical trials and help predict their rate of decline, Graff-Radford said.
  • “There’s a dearth of researchers and geriatricians from a time when we could not fund Alzheimer’s and related dementias,” said Maria Carrillo, Alzheimer’s Association in Chicago.
  • Knopman said scientists need to better define the syndromes and etiologies they study and describe them with more precise language. Among Alzheimer’s and Parkinson’s researchers, entrenched debates about terminology have arisen because clinicians classify diseases based on symptoms, whereas pathologists classify them based on molecular pathologies.

Here is a link to the full write-up: