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If It Walks Like and Quacks Like…

We have all heard that we Americans are living longer, and that is a good thing generally speaking.  It seems, however, that living longer also exposes those with greater longevity to medical conditions that don’t affect younger adults.  One of them is within the category of dementia with a long name that they abbreviate to LATE (Limbic-predominant age-related TDP-43 encephalopathy).  You can see why the abbreviation.

You have heard of the telltale deposits of beta-amyloid that are the hallmark of Alzheimer’s disease.  LATE has TDP-43 protein deposits on the brain that impair cognitive function, and among people 85 years of age and older the odds are one in four that they will develop this neurologic condition. Okay, you might say, it is just another of the nearly one hundred kinds of dementia.  It is important, in no small part, because before physicians identified this unique dementia it was just one more chance for a misdiagnosis, and where there is a misdiagnosis, treatment is going to be wrong also.

All the more reason to get a specialist to diagnose any cognition issue your older loved one may be manifesting.  One of our team shared that his mom had been diagnosed with “organic dementia.”  It was a diagnosis by her primary care physician who promptly prescribed Namenda.  Follow this now.  First, Namenda is approved by the FDA to treat Alzheimer’s disease.  Second, it is meant to be used in combination with the first line medication, Aricept.  Third, it turns out she did not have Alzheimer’s…she had vascular dementia.  Never mind that this would have been medications that together would cost between $500 and $900 per month…and have absolutely no effect on his mother’s condition.

So, misdiagnosis leads to more problems than just not addressing the medical condition properly.  It is about not getting the right treatment and not helping caregivers to the patient understand what part of the brain is compromised so that they are attentive to the unique needs a patient will have based on their condition.  When our team mate pointed out the discrepancy with the “organic dementia” and the Alzheimer’s meds, the doctor sneered, “So, it’s the cost of the medicine?”  You can see where misdiagnosis can go. The need to reliably identify what type of dementia is clear.

If it walks like a duck and quacks like a duck, it still is only walking like and quacking like a duck.  Ask an ornithologist what type of fowl it is!  Or, in this case a neurologist.

Charlotte Bishop is an Aging Life Care Advisor, 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.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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