Chief of the Division of Geriatrics at the Brody School of Medicine, is flying into Tahoe to talk about "Dementia, Depression & Delirium" tomorrow to start off our Nevada Academy of Family Physicians' 43rd Annual Winter Conference. I mention this because perhaps I was too harsh yesterday when I wrote about the use of florbetapir for the diagnosis of Alzheimer's disease.
After all, without an ability to make the diagnosis and follow its progression, it's difficult to search for potential cures. So while florbetapir might not have direct clinical application on a day-to-day basis for the average clinician practicing in the trenches today, it could certainly be used to assess the utility of various preventive techniques and potential pharmaceutical agents.
Following that same line of thought, I decided that in all fairness, I should also mention an article published in that same issue of JAMA this past week looking at the efficacy of plasma beta amyloid levels to potentially detect & predict cognitive decline in 997 adults followed for 10 years. More good news out of this study was that cognitive reserve (as approximated by years completed of schooling plus literacy level) appeared to attenuate the loss expected with a lower level of plasma beta amyloid.
Now before you race over to your doctor and ask for the test, do realize that it's not ready for prime time. In other words, it hasn't been approved by the FDA, much less been commercialized. If anything, this is the beginning of a proof of concept that perhaps beta amyloid is the cause of Alzheimer's disease and not a by-product.
However these two testing modalities turn out, I offer them as examples of our continued attempts to develop a more objective way to make the diagnosis, follow its progress, and find a cure. While we have none of the three right now, hope is just over the horizon. In the meantime, stay physically & mentally active and eat low glycemic, non-processed foods akin to the Mediterranean diet in our best attempt to prevent cognitive decline.
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