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Alzheimer’s Early and Accurate Diagnosis: Normal Aging vs. Alzheimer’s Disease

(Editor’s Note: I recently came across an excellent book and resource, The Alzheimer’s Alzheimer's Disease Action PlanAction Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems, just released in paperback. Dr. Murali Doraiswamy, one of the authors and leading Alzheimer’s expert, kindly helped us create a 2-part article series to share with SharpBrains readers advice on a very important question, “How can we help the public at large to distinguish Alzheimer’s Disease from normal aging — so that an interest in early identification doesn’t translate into unneeded worries?” What follows is an excerpt from the book, pages 3-8).

Jane, fifty-seven, managed a large sales force. She prided herself on being good at names, and introductions were easy for her—until last spring when she referred to Barbara as Betty at a meeting and had to correct herself. She started noticing that her memory wasn’t as dependable as it once was—she had to really try to remember names and dates. Her mother had developed Alzheimer’s in her late seventies, so Jane entertained a wide array of worries: Is this just aging? Is it because of menopause? Is it early Alzheimer’s? Did her coworkers or family notice her slips? Should she ask them? Should she see a doctor, and if so, which doctor? Would she really want to know if she was getting Alzheimer’s? Would she lose her job, health insurance, or friends if she did have Alzheimer’s?

As it turns out, Jane did not have Alzheimer’s. She consulted a doctor, who, in docspeak, told her that the passage of time (getting older) had taken a slight toll on her once-superquick memory. She was slowing down a little, and if she relaxed, the name or date or other bit of information she needed would come to her soon enough. She was still good at her job and home life. She had simply joined the ranks of the worried well.

Normal brain aging, beginning as early as the forties in some people, may include:

• Taking longer to learn or remember information
• Having difficulty paying attention or concentrating in the midst of distractions
• Forgetting such basics as an anniversary or the names of friends
• Needing more reminders or memory cues, such as prominent appointment calendars, reminder notes, a phone with a wellstocked speed dial

Although they may need some assistance, older people without a mental disorder retain their ability to do their errands, handle money, find their way to familiar areas, and behave appropriately.

How does this compare to a person with Alzheimer’s? When Alzheimer’s slows the brain’s machinery, people begin to lose their ability to Read the rest of this entry »

Shall we question the brand new book of human troubles

With three years still left until publication, the fights over the new version of the psychiatric diagnostic manual, the DSM-V, are hotting up and The New York Times has a bookconcise article that covers most of the main point of contention.

- “What you have in the end,” Mr. Shorter said, “is this process of sorting the deck of symptoms into syndromes, and the outcome all depends on how the cards fall.”

- Psychiatrists involved in preparing the new manual contend that it is too early to say for sure which cards will be added and which dropped.

Although I doubt the DSM committee are using that exact metaphor, it certainly illustrates the point that the process requires a certain degree of value-judgement.

It’s interesting, however, that the public debate is currently focused on whether certain diagnoses should be included or not, rather than whether diagnosis itself is useful for psychiatry.

We’ve had psychometrics for a good 100 years that allow us to measure dimensions of human experience and performance with a much greater degree of accuracy than Read the rest of this entry »

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