Alzheimer’s disease can have symptoms other than
memory loss
Newswise, September 14, 2016 --- Relying on clinical symptoms
of memory loss to diagnose Alzheimer’s disease may miss other forms of dementia
caused by Alzheimer’s that don’t initially affect memory, reports a new
Northwestern Medicine study.
“These individuals are often overlooked in clinical trial
designs and are missing out on opportunities to participate in clinical trials
to treat Alzheimer’s,” said first study author Emily Rogalski, associate
professor at Northwestern’s Cognitive Neurology and Alzheimer’s Disease Center.
There is more than one kind of Alzheimer's disease.
Alzheimer’s can cause language problems, disrupt an individual’s behavior,
personality and judgment or even affect someone’s concept of where objects are
in space.
If it affects personality, it may cause lack of inhibition.
“Someone who was very shy may go up to grocery store clerk -- who is a stranger
-- and try to give her a hug or kiss,” Rogalski said.
This all depends on what part of the brain it attacks. A
definitive diagnosis can only be achieved with an autopsy.
Emerging evidence suggests an amyloid PET scan, an imaging
test that tracks the presence of amyloid -- an abnormal protein whose
accumulation in the brain is a hallmark of Alzheimer’s -- may be used during
life to determine the likelihood of Alzheimer’s disease pathology.
In the study, the authors identify the clinical features of
individuals with primary progressive aphasia (PPA), a rare dementia that causes
progressive declines in language abilities due to Alzheimer’s disease. Early on
in PPA, memory and other thinking abilities are relatively intact.
PPA can be caused either by Alzheimer’s disease or another
neurodegenerative disease family called frontotemporal lobar degeneration. The
presence of Alzheimer’s disease was assessed in this study by amyloid PET
imaging or confirmed by autopsy.
The study demonstrates that knowing an individual’s clinical
symptoms isn’t sufficient to determine whether someone has PPA due to
Alzheimer’s disease or another type of neurodegenerative disease.
Therefore, biomarkers, such as amyloid PET imaging, are
necessary to identify the neuropathological cause, the authors said.
Northwestern scientists looked at individuals in mild stages
of language loss caused by Alzheimer’s disease and described their brain
atrophy based on MRI scans and their results on cognitive tests.
“We wanted to describe these individuals to raise awareness
about the early clinical and brain features of PPA to develop metrics which
would advocate for their inclusion in clinical trials targeting Alzheimer’s
disease,” Rogalski said.
“These individuals are often excluded because they don’t have
memory deficits, but they share the same disease [Alzheimer’s] that’s causing
their symptoms.”
The study was published online in the journal Neurology Aug.
26.
Dr. Marsel Mesulam, director of the Cognitive Neurology and
Alzheimer's Disease Center and the Ruth Dunbar Davee Professor of Neuroscience
at Northwestern University Feinberg School of Medicine, is senior author of the
paper.
The study was funded by grants DC008552 from the National
Institute on Deafness and Other Communication Disorders, AG13854 from the
National Institute on Aging, NS075075 from the National Institute of
Neurological Disorders and Stroke, all of the National Institutes of Health.