When Dad started having trouble finding words, he went to see his family physician. The doctor dismissed his concerns. “I’d know it if you had problems,” he said. He was wrong about Dad, and studies published this year show he may have been wrong in general.
In the May issue of Archives of Neurology, Mayo Clinic researchers published the results of their analysis of the brains of 15 people who had died while they had a diagnosis of Mild Cognitive Impairment. The researchers compared the brains to those of 28 people who had had no memory problems and 23 who had been diagnosed with probable Alzheimer’s disease. The level of pathologies in the brains of the people with Mild Cognitive Impairment was in between that of patients diagnosed with probable Alzheimer’s disease and that of those with no memory problems. The study authors concluded that their findings suggest Mild Cognitive Impairment is “a transitional state of evolving AD [Alzheimer’s disease].”
In the September issue of Neurology, scientists at Dartmouth Medical School in Hanover, New Hampshire wrote about their study of brain volume in patients diagnosed with Mild Cognitive Impairment. They performed MRI scans on the brains of 40 people who had normal scores on neuropsychological tests, but complained about memory problems. The researchers compared these scans to those of two other groups: 40 people diagnosed with Mild Cognitive Impairment and 40 healthy volunteers with no memory complaints. In the group with normal test performances but memory complaints, the decrease in gray matter volume was similar to that in those diagnosed with Mild Cognitive Impairment. The greater the memory problems reported by participants, the more volume had been lost.
The idea that abnormal brain degeneration starts long before people have clinical signs of dementia isn’t really new. Scientists at Vrije Universiteit in Amsterdam had previously found that brain volume in people diagnosed with Mild Cognitive Impairment seemed to be at an intermediate stage between that of healthy volunteers and those diagnosed with Alzheimer’s.
If my father’s doctor had ordered an MRI when Dad first mentioned memory problems, the scan might have shown signs of atrophy. But what good would that have done? There’s no drug to stop the progression of either Alzheimer’s or the cerebral amyloid angiopathy (CAA) Dad had. There’s not even agreement about what should be included in the criteria for diagnosis of Mild Cognitive Impairment.
This lack of understanding is exactly why I think you should be tested if your memory isn’t what it used to be. Whether or not your test results show a problem, you might be able to contribute to Alzheimer’s and dementia research. Try to have your testing done at a memory clinic, university or an Alzheimer’s Disease Research Center that will use your results in studies.
Especially if you’re in the US, don’t forget to ask how much you will be charged for any testing. You might be able to find programs you can participate in at no cost. We sent Dad’s MRI scans, other medical records and brain tissue to Dr. Steven Greenberg to get a second opinion on autopsy results and to try to help with his research on CAA and Alzheimer’s. This summer, I went through the testing for the Wisconsin Registry for Alzheimer’s Prevention. There was no charge for participating in either of these research efforts.
Someday doctors will be able to accurately diagnose and treat degeneration of the brain. Until then, participating in research programs is one way we can help.