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Want to fight alzheimers? Support stem cell research.
She and her husband went to the Adler Institute for Advanced Imaging in Jenkintown on a recent morning after 70 tests over the last year failed to explain her worsening symptoms. She was going to try yet another: a newly approved test developed by a Philadelphia biotech firm. It uses a PET scanner and a radioactive tracer - Amyvid - that binds to amyloid, one of the hallmark proteins that accumulate in the brains of Alzheimer's patients. Until recently, the only sure way to know whether people had Alzheimer's was to examine their brains after death.
The Food and Drug Administration approved the test in April. It is both a sign of the future of dementia treatment - enabling doctors to identify people at risk for a dread disease even before they have symptoms - and an example of the challenging economic and medical issues new technology so often raises. The test is costly and possibly confusing. There is now no good, long-term Alzheimer's treatment. The diagnosis could subject patients to discrimination by employers and insurers, let alone intense anxiety.
Claudia Kawas, a geriatric neurologist at the University of California, Irvine, said a patient strode into her office soon after the FDA approved the procedure and asked for the "Alzheimer's test." In one hand, he held an article about the approval of Amyvid. In the other, he had a document from a right-to-die group. If the test was positive, he told her, he would get his affairs in order and kill himself within 60 days. Although she thinks the test can be useful, she was glad her center didn't have it. She says she wouldn't have it done on herself, though she's noticing some memory changes. "The information, I think, wouldn't help me in any way," she said.
The Adler patient, who asked that her name not be used, is a former college English major who is having trouble finding words, thinking clearly, and understanding even slightly complicated reading material. On a recent shopping excursion, her sister found her wandering aimlessly. She's having memory, spatial, and balance problems, and has given up driving. Alzheimer's would be unusual at her age, but an earlier PET scan showed a pattern suggestive of the disease. The new test would support that diagnosis or rule it out. The patient and her husband, who met on her 21st birthday and became engaged six weeks later, want to know what to tell their children, how to face their future, however bleak it may be. Still, the woman hoped their search for a diagnosis would not end with this test. "Alzheimer's at this age is a pretty scary endeavor."
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