Alzheimer’s Disease and Dementia

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Early detection and new Medicare policy pave way for better prognoses

By Robert Frankel

The first step in the treatment of a disease is a diagnosis; without it, any future care would lack the specificity to address, and perhaps cure, the disease.

So it may be shocking to hear that for Alzheimer’s disease, and other related dementias, many patients may not even have the chance for treatment until far too late.

“About 20 percent of people never get a diagnosis,” said Dr. Mary E. Quiceno, “and many people never get a specific diagnosis for their dementia.”

Dr. Quiceno is an Associate Professor of Neurology and Neurotherapeutics at UT Southwestern Medical Center. She is heavily involved in community outreach, and is also active in researching Alzheimer’s disease, Alzheimer’s-related dementia, and other related neurodegenerative disorders.

Her research focuses on prevention and disease modification. She explained that a number of recent discoveries have allowed researchers to “see” Alzheimer’s. MRIs, and other mapping technologies, of patients with the disease show certain kinds of biological changes in the brain. Researchers are studying these changes, labeling them “biomarkers.”

One major component of Dr. Quiceno’s research centers on people who don’t have Alzheimer’s right now, but who may have biomarkers indicative of the disease. The goal is to provide a definitive diagnosis early — at best, years ahead of the onset of symptoms.

For now, Dr. Quiceno said that early detection of Alzheimer’s disease, and any other dementia, is key. A recent policy change from the Centers for Medicare and Medicaid Services (CMS) may help make that imperative more feasible for millions of people.

The CMS finalized a decision to pay for assessments and care planning for patients suffering from cognitive impairments, such as Alzheimer’s disease. Medicare beneficiaries are now eligible for coverage of comprehensive care planning services, and also a specific diagnosis.

“I’ve had more than one patient say to me, ‘I wish you would have told me I have cancer, because at least there is something I could do about it,’” Dr. Quiceno said. “That just broke my heart to hear that… I want to be honest about what we’re dealing with, the treatments I do have. That, to me, is why the research is so important: It’s hope for families.”

Dr. Quiceno said she and other researchers all over the country are looking for more people to volunteer for studies. Families and individuals interested in taking part are encouraged to visit the Alzheimer’s Association at www.alz.org. Once there, click on the “Research” tab, and set up a profile for TrialMatch.

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