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Predicting Dementia

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care managers and dementiaWhen I speak with clients about dementia, there are usually three kinds of questions that come up a lot. The first is whether there is a cure, or at least an effective treatment for dementia? The second is does my loved one have dementia? The third question is something along the lines of what are my or my loved one’s chances of developing dementia? The answer to number one is that the current treatments for dementia are modestly effective in slowing the progression of the condition, and there is no cure yet. But a lot of researchers are intensely at work on new treatments. For number two, MRIs and other imaging technologies as well as cognitive tests can give us clearer assessments of Alzheimer’s progressive erosion of the brain. And it turns out that there are good answers in the works for the third question with recent results from two teams of researchers.

A doctor and his team from the Division of Cognitive Aging and Dementia at Albert Einstein College of Medicine, New York City have recently published their findings on tests for predicting what they refer to as “amnestic mild cognitive impairment” and dementia. The test is called the Memory Binding Test, and it can be done in a doctor’s office in only about ten minutes. The MBT measures what scientists call associative binding; that is how we link one event or thing with another event or thing. In a study with almost three hundred patients, researchers took a baseline measure of their associative binding with the test. They followed these people for ten years and found that people who did poorly on the test at baseline were twice as likely to develop dementia as those who did well on the test. The only other reliable tests up until now have been imaging tests for amyloid plaque, so this test could prove not only hugely less expensive, but also be more reliable even before dementia manifests itself in brain images.

A second study was also recently reported, and it links adult-onset diabetes with dementia. You may recall an earlier posting on what some are calling type 3 diabetes…dementia. It turns out that developing type 2 diabetes may be also be a good predictor of the dementia that will follow, especially as they both have elevated cholesterol, hypertension and obesity in common. For this research, the scientists followed more than 200,000 individuals over age 65. They found that even after taking into account other risk factors for dementia that the presence of type two diabetes increased the risk of adults developing Alzheimer’s disease by one and a half times. The risk for vascular dementia was increased 2.5 times among those with type 2 diabetes over those without type 2 diabetes.

The upshot from these studies may be twofold. For the first, it is a less expensive way to determine if certain patients who test positive cognitively should be more closely monitored so that they receive treatment that slows the progression of dementia earlier in the disease. In the case of the second study, we have one more very good reason to manage our cholesterol, blood pressure and weight.

Charlotte Bishop is an Aging Life Care Professional and a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.

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