This segment focuses on medical diagnoses for Alzheimer’s disease, Lewy body dementia and Parkinson’s. The field is rapidly changing. We now have biological markers for Alzheimer’s: mis-folded proteins in the brain is the common thread for all degenerative diseases, including Parkinson’s disease, Lou Gehrig’s disease, and frontotemporal degeneration Pick’s Disease. Being able to visualize these in PET scans (Positron Emission Tomography) lets us make a definitive diagnosis 15 years before someone begins having memory problems.
Suzanne Newman talks with Dr. Michael Mega, Director of the Center for Cognitive Health in Portland, Oregon. The center helps patients maximize their cognitive function as they cope with Alzheimer’s disease and disorders of thinking.
Blood tests are also being developed to measure the amount of these proteins in the brain that leak out through cerebral-spinal fluid into the blood, which will identify people on the Alzheimer’s trajectory.
Many types of treatments are being developed to stop the mis-folding and deposition of plaque in the brain, as well as the mis-folding and deposition of tangles in the brain. The goal is that people would be able to take a blood test during their yearly physical, and if they’re identified as being on the trajectory, we could then institute disease-modifying drugs to keep them from getting Alzheimer’s if they haven’t developed memory problems.
Lewy body dementia and Parkinson’s look the same in terms of the mid-folded proteins. It’s where the proteins are deposited that produces different manifestations of these diseases. If these proteins are deposited on the brain stem or subcortical structures, and produce damage, those manifest as slowness in moving, tremors, as well as gait and balance difficulty. If they proteins are primarily deposited on cortical structures as well as the brain stem, that produces more cognitive issues, resulting in problem-solving difficulties, visual-spacial issues, hallucinations, as well as fluctuations in attention. If they have three of the following — a REM-behavioral sleep disturbance where you act out your dreams during your sleep, visual hallucinations while awake, fluctuations in attention or alertness, and neuroleptic sensitivity — as well as a family member who says the person cannot safely live alone, we would diagnose Lewy body dementia. That’s different for Parkinson’s patients, where only 50 percent will develop a thinking problem where their family says they no longer safe. Most patients don’t have thinking problems in the beginning stages of the disease. So the clinical distinction is stark even though the pathology is due to the same mis-folded protein.
Learn more at the Center for Cognitive Health. Visit shapetrial.com to learn about a trial for Parkinson’s Disease Dementia. Visit lift-adtrial.com to learn about the LIFT-AD Alzheimer’s Disease trial. You can also learn about trials taking place at the Center for Cognitive Health in Portland. Brought to you courtesy of Athira Pharma.
