Do Clinical Tests for Alzheimer's Miss the Highly Educated?

Contributed by: Dennis Fortier, President, Medical Care Corporation

With the forthcoming changes to regulations by National Health Services in the U.K., many Alzheimer's patients who have formerly been denied treatment with cholinesterase inhibitors may soon have the opportunity to benefit from such treatment. With that in mind, a story in today's Telegraph raises an interesting point.

The point is that the Mini Mental State Exam (MMSE), a short test of memory and judgment used by many physicians to detect cognitive problems, is not sensitive enough to distinguish early stage Alzheimer's disease from subtle symptoms associated with normal, healthy aging. As such, many people, particularly those who are highly educated, might continue to pass that test until deep into the progression of a debilitating disease like Alzheimer's. These people, it is argued, would be presumed healthy and neither evaluated further nor treated for any emerging problem. It's a valid point.

The solution is for clinicians to embrace a newer generation of assessment tools suited for a primary care environment. A comprehensive, expert review of such technologies is currently underway through the non-profit organization Prevent AD 2020. A summary of their findings is expected to be published in the Journal of Alzheimer's & Dementia (the journal of the National Alzheimer's Association) early in 2011.

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