Archive for April, 2013

I read yet another newspaper article on Alzheimer’s disease touting “early diagnosis.” Now that it is clear that brain changes of Alzheimer’s disease develop decades before there are symptoms, the push is to make a medical diagnosis well before there are any symptoms. Furthermore, if we pursue this strategy, many (based on current data as many as 30%) will be diagnosed who will never develop symptoms. We will instill fear and hopelessness needlessly. “Alzheimer’s disease’ a label that has no usefulness in the real world. Everyone with Alzheimer’s disease does not become demented. The label provides a false level of understanding along with an expectation that there is nothing that can be done. There are effective treatments for memory loss but they are not medical and therefore undervalued. Furthermore, a diagnosis should direct you to actions that tell you what […]


The second most feared medical diagnosis – next to cancer – is Alzheimer’s disease, the most common cause of dementia.   What is Alzheimer’s disease?  This not such an easy question to answer as it may seem.  Ultimately, the diagnosis requires confirmation by autopsy or biopsy but even here the diagnoses is uncertain.  A diagnosis is made by clinical criteria based on typical features. “Typical Alzheimer’s disease” mainly affects the elderly – onset over 65.   Most often Alzheimer’s disease is “sporadic” – meaning there is no prior family history.  The symptoms do not develop rapidly but rather come on slowly over the course of many years.  The first sign of possible Alzheimer’s disease is short-term memory slips such as forgetting conversations, getting lost, or forgetting events.  As the condition progresses there are deficits in skills in addition to memory such as […]


It has become increasingly clear that most progressive dementias slowly unfold over the course of several decades.  For example, Alzheimer’s disease forms decades before there are any signs or symptoms.  It doesn’t appear suddenly or show up as a “conversion” from Mild Cognitive Impairment.   This is good news.  We can be proactive by life style and planning years ahead instead of just reacting to changes after they occur.  Life style interventions must start decades before problems show themselves.  The issue to resolve is what life style changes is worth the effort.  Exercise is the one factor that is emerging as a clearly protective of the brain.  Many short-term studies have suggested that increasing levels of fitness now pays benefits for future brain health.  The Cooper Center Longitudinal Study, Cooper Clinic in Dallas, published a study that prospectively followed a large […]

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