Early Detection: Why it Matters

Medical experts agree: early detection of cognitive impairment is critical for managing progressive dementias like Alzheimer’s disease.

Most of us think of dementia as a disease of the very old. However, the Centers for Disease Control and Prevention (CDC) has reported on adults as young as 45 years old who are exhibiting Subjective Cognitive Decline (SDC), defined as confusion or memory loss that has worsened since the previous year.

In addition to those at age 45 who may start demonstrating symptoms of cognitive decline, research has shown that changes in the brain leading to dementia can actually begin up to 15 years before any symptoms appear.

Early diagnosis

Diagnosis of the early stages of dementia is a growing field. New trends include the addition of biomarkers to the diagnostic toolbox. Blood biomarkers, in particular, have been at the forefront of diagnosis.

Biomarkers are a new approach to the previously available, specialized diagnostic tests, like analysis of cerebrospinal fluid, PET scans, MRIs. New blood tests, for example, test for proteins in the brain that are associated with dementia. More and more, these blood biomarkers are demonstrating high accuracy.

Blood biomarkers, in fact, are now part of new diagnostic guidelines set forth by the Alzheimer’s Association International Conference in 2023. The guidelines help clinicians diagnose dementia as they would other diseases such as diabetes and heart disease.

Doctors also now can use a seven-point rating scale for dementia diagnosis. Like the stages of cancer, a numerical staging system assesses the progression of the disease, hopefully leading to a more personal approach to diagnosis and treatment. A Scale 0 has even been included for people who carry genes that guarantee they will develop Alzheimer’s.

Some researchers and clinicians are also exploring innovative diagnostic techniques, such as using virtual reality technology as an assessment tool for people at risk, new brain-scanning techniques, and even the use of Artificial Intelligence as a diagnostic tool years before symptoms appear.

Treatments for early memory loss

Recently, researchers have studied medications and treatments that can modify memory impairment in its early stages. These include the FDA-approved drugs aducanumab and lecanemab, which can remove abnormal proteins in the brain associated with memory loss and thereby perhaps slow cognitive and functional decline in people with early Alzheimer’s.

While research continues, protocols exist for treating symptoms of cognitive impairment that may or may not necessarily lead to Alzheimer’s disease. Called Mild Cognitive Impairment (MCI), these symptoms include changes to memory or memory function—such as trouble recalling or thinking clearly—and problems with language or judgment that are not serious enough to impact one’s daily life. Many of the same risk factors as Alzheimer’s disease can come into play when assessing and treating MCI.

By seeking early diagnosis, it is hoped that people can gain more awareness of dementia diseases and prepare accordingly, including medical planning and seeking emotional and financial advice and support. Additionally, they may consider engaging with researchers in developing and testing new treatments that arise for both slowing progression and managing symptoms.

Notes: CDC data is from Centers for Disease Control, “Morbidity and Mortality Weekly Report,” May 20, 2022/71 (20): 680–685. Biomarkers include blood pressure, body weight, or laboratory tests of blood, urine, or tissues.