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Beyond the Symptoms: Defining Alzheimer's Disease

Jun 15, 2018 by Larry Morgan

Neurodegenerative disorders are incredibly confusing, which makes them even more devastating than they already are. Alzheimer’s is just one example of this kind of disease, accounting for almost 85% of all dementia cases.

And while the focus has been on finding “the cure,” or at least effective treatments for the disease, a new proposal argues that perhaps changing the definition of the condition will help matters:

Symptoms Do Not Define the Disease

Previously, the way to understand and diagnose Alzheimer’s disease has been syndromal, or based on the disease’s symptoms. Changes in cognition such as memory loss, change in mood or behavioral issues were used to diagnose individuals at Alzheimer’s different stages.

But this method is actually quite misleading. Not everyone shows symptoms the same way, and those who have Alzheimer’s do not all have overt symptoms from the start. This leads to late diagnoses in many cases, which reduces treatment efficacy.

Instead, scientists agree that the most rational way to help prevent (or at least) delay symptoms from even occurring is through a biological diagnosis.

Biomarkers Make the Difference

Focusing on biomarkers can be an effective way to do just that.

Because biomarkers indicate presence of the disease, a diagnosis can be scientifically confirmed – with or without the presence of stereotypical Alzheimer’s symptoms.

Researchers also hypothesize that by changing to a more biological definition of the disease, they may be able to more accurately and effectively find out what causes cognitive impairment to occur, and how multiple causes can lead to it.

Getting on the Same Page

Another component of this new definition would be to set up a common language in regards to Alzheimer’s.

Just as police, hospitals, military, and others have certain codes they use to indicate different things, a common language used for Alzheimer’s may help everyone get on the same page. For example, if one scientist defines Alzheimer’s as the presence of X amount of tau tangles, whereas another defines it as the presence of dementia, those two definitions cannot be accurately compared, as both signs may indicate Alzheimer’s in inaccurate ways.

Not Restrictive, but Instead Broadening

The researchers proposing this change in definition want to make it very clear that it is not meant to restrict Alzheimer’s research in regards to symptoms or the like. They stress that if anything, it can broaden research and inspire new ways to think about Alzheimer’s and possible treatments.

One way it broadens research is by expanding treatment options via tailored/personal treatment. For example, if two patients both have biomarkers for the disease present, but only one is showing symptoms, a different treatment approach may be taken on each individual. Heavier prevention methods may be pushed onto the asymptomatic patient, whereas the one showing symptoms already may need treatment for those most bothering them.

This proposed framework does need to be explicitly examined and tested, but it could expedite the search for a cure for this horrendous disease, and others like it.

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