Among the ways researchers are identifying Alzheimer's are through genetic analysis and with biomarkers that can be seen on PET and MRI scans and in cerebrospinal fluid.
These include finding disorders in beta amyloid metabolism and the molecules tau and phospho-tau in cerebrospinal fluid.
In addition, since 1984 there has been a better understanding of the differences between Alzheimer's disease and other types of dementia.
Much more is known about dementia caused by Lewy Body disease and Pick's disease and other frontotemporal dementias.
The proposed changes in diagnosing Alzheimer's will take into account preclinical disease, which can help identify Alzheimer's before symptoms appear; mild cognitive impairment, which can be the first signs of Alzheimer's; and looking into recommending specific biomarkers, which can aid in diagnosis.
Goldstein noted that these proposed changes will lead to new problems, including who should be screened and at what cost. "These changes have significant economic service delivery implications. It has significant public health implications, but it's ultimately a worthy goal," he said.
In addition, there are no effective treatments for Alzheimer's. "Current treatments are primarily symptomatic," Goldstein said. "The ultimate goal is stopping the pathological process long before it develops a momentum that can't be stopped."
Another expert, Mony de Leon, director of the Center for Brain Health at NYU Langone Medical Center in New York City, called the proposed changes "long overdue."
The ultimate goal is to find a treatment for Alzheimer's, de Leon said. "But unless you know who needs the drug, how do you develop a drug?" he stated. "You need the early diagnosis before you can even consider the prevention work."
David Loewenstein, a professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, added that
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