The first new guidelines in 27 years for the diagnosis of Alzheimer’s disease could double the number of Americans defined as having this devastating illness. This week, The Alzheimer’s Association and the U.S. National Institute of Aging release the new guidelines that expands diagnosis among significant other changes.

A major goal of the long being developed guidelines is to refine existing guidelines for diagnosing mild cognitive impairment (MCI). People with MCI experience a decline in memory, reasoning or visual perception that’s measurable and noticeable to themselves or to others, but not severe enough to be diagnosed as Alzheimer’s or another dementia.

MCI will become a new diagnosis, and that could mean that the number of people considered to be on the new Alzheimer’s continuum could double.

The new highlight document states:

“”The new guidelines formalize an emerging consensus that everyone who eventually develops Alzheimer’s experiences this stage of minimal but detectable impairment, even though it’s not currently diagnosed in most people. However, although everyone with Alzheimer’s experiences an MCI stage, not everyone with MCI eventually develops Alzheimer’s. MCI may also occur for other reasons. The guidelines designate the condition of minimal impairment preceding Alzheimer’s as ‘MCI due to Alzheimer’s disease,’ and define four levels of certainty for arriving at this diagnosis.”

The guidelines for MCI due to Alzheimer’s disease include specific biomarkers that may be used now in research settings, with the expectation that these recommendations are a work in progress that will evolve as knowledge advances. Understanding signature biomarkers may reveal how these benchmarks change over time, enabling more precise and clinically useful characterization of all stages of Alzheimer’s.

The document specifically emphasizes however that these revisions are unlikely to change what happens in doctors’ offices when diagnosing Alzheimer’s or its precursors.

Dr. Guy M. McKhann, one of the guideline authors stated:

“It will not change practice. The new guidelines make a clearer distinction between Alzheimer’s dementia and vascular dementia (such as that caused by stroke). The diagnosis will still be made by a doctor, with help from someone who knows the patient and perhaps the patient him or herself, but biomarkers may be called in to augment our certainty about the diagnosis.”

MCI can represent an earlier phase of dementia and consists of modest impairments, primarily in memory, which can be a harbinger of full-blown Alzheimer’s in the years to come. Scientists will be working towards standardizing biomarkers which indicate, for example, the presence of amyloid protein or nerve damage in the brain.

In the immediate future, how diagnoses are made will be extremely similar to what’s been used in the last 10 years said Marilyn Albert, director of the division of cognitive neuroscience at Johns Hopkins. She continues:

“We’re worried that there could be drugs around now that could be beneficial but that we could be using them too late in the disease course.”

William Thies, chief medical and scientific officer of the Alzheimer’s Association gives a quick summary:

“(The guidelines) will result in little change in current clinical practice of medicine as applied to Alzheimer’s disease. . . . (However) the new criteria are really extending the range of our ability to investigate this disease and eventually to find treatments that will be so necessary to avoid the epidemic of Alzheimer’s that we see facing us.”

Read the eleven page summary HERE.

Source:Alzheimer’s Association

Written by Sy Kraft