Clinical Neurosciences Center

U Leader Speaks Out

Seize the Moment: Diagnose Alzheimer’s Before Dementia Onset, U of U Expert Urges

New advances make it possible to recognize changes of Alzheimer’sdisease earlier than ever. In the August 2007 issue of the medical journal Lancet Neurology, Norman L. Foster,M.D., Director of the University of Utah Center for Alzheimer’s Care, Imaging, and Research, writes that now is the time to update the criteria for diagnosing Alzheimer’s disease.

In a commentary on proposed new diagnostic criteria published in the same issue, Foster writes that advances in imaging technology and genetics, combined with greater understanding of the disease, now make it possible to identify Alzheimer’s even before dementia develops. Dementia is a symptom, and Alzheimer’s disease is only one of the many causes of dementia. Traditionally, Alzheimer’s disease is diagnosed only after dementia occurs. Indeed, the general public and even some professionals today often use the terms dementia and Alzheimer’s disease interchangeably. Recognizing biological evidence of Alzheimer’s disease in tests can help physicians and researchers distinguish between it and other memory disorders. Physicians can disagree about whether someone has symptoms severe enough to be called dementia. The proposed criteria also would solve this problem. This new approach could improve care for patients, says Foster, U Professor of Neurology and internationally regarded Alzheimer’s expert.

“The time is right to use the advanced technology at our disposal to improve the early, accurate diagnosis of dementia and develop more effective treatments,” Foster writes.

Current criteria for Alzheimer’s are 25 years old and based on recognizing clinical symptoms, without taking advantage of new technology. The international group of experts in the Lancet Neurology article proposes that biological tests and objective evidence of memory loss alone are sufficient for diagnosis. Foster endorses the idea andsays this new framework for diagnosis is a good starting point for future research. He says the criteria are not yet ready for routine use in doctors’ offices, but “this new approach should quickly be adopted following standardization and validation”, speeding treatments to patients and their families.

As the U.S. population ages, Alzheimer’s is expected to strike more people, and Utah and the Intermountain West are expected to have the nation’s greatest increase in the disease over the next two decades.