One of the most devastating disorders associated with aging, dementia causes a progressive loss of the ability to think, remember, and reason. Early disease stages may cause only minor memory lapses and difficulty paying attention. But over time, it can rob patients of speech, movement, and even the capacity to recognize loved ones. Eventually, the underlying disease can prove fatal.
Diagnosis: Grappling with uncertainty
The most common forms of dementia
Dementia is a general term that describes symptoms such as memory loss and impaired thinking. Researchers now know that the symptoms of dementia can be caused by a variety of disorders of the brain.
The most common include [2,3]:
A lot of the diagnosis still depends on the report of relatives, who are often the first to notice changes in memory or personality and can describe changes over time.
Professor Clare Mackay, PhD, Associate Director
Oxford Centre for Human Brain Activity (OHBA), UK
If a primary care doctor suspects dementia, the patient may be referred to a specialist or specialty clinic, where a variety of different tests may be performed, including:
The pinch point is those patients where the clinical data is contradictory or unreliable.
Nick Fox, MD, Director
Dementia Research Center
University College London, UK
On the horizon: New and more precise tests
Many of us in the field believe that the combination of AI plus network analysis will be very useful in understanding the systems biology of dementia.Andrew Saykin, PsyD, Director
Indiana University (IU) Alzheimer’s Disease Research Center and IU Center for Neuroimaging
Treating Alzheimer’s: a new era?
We will need algorithms to help primary care physicians determine which patients they should refer to specialists or specialty clinics, as well as models that simplify diagnostics.Professor Oskar Hansson, PhD
Lund University, Sweden
All sources last accessed August 16, 2021
 Dementia Statistics, Alzheimer’s Disease International. https://www.alzint.org/about/dementia-facts-figures/dementia-statistics/
 “Dementia: Assessment, management and support for people living with dementia and their carers” National Institute for Health and Care Excellence: Dementia: Clinical Guidelines National Institute for Health and Care Excellence (UK); 2018 Jun. https://pubmed.ncbi.nlm.nih.gov/30011160/
 “Diagnosis and Management of Dementia: A Review” JAMA. 2019 October 22; 322(16): 1589–1599. doi:10.1001/jama.2019.4782.
 Alzheimer’s Association, “What is Dementia?” https://www.alz.org/alzheimers-dementia/what-is-dementia
 National Institute on Aging, “Symptoms and Diagnosis of Alzheimer’s Disease.” https://www.nia.nih.gov/health/alzheimers/symptoms
 “Developing the ATX(N) classification for use across the Alzheimer disease continuum” Nature Reviews Neurology; 2021 July 8. https://pubmed.ncbi.nlm.nih.gov/34239130/
 “Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinicl and Prodromal Alzheimer Disease,” JAMA Neurology; 2021 78(8), 961-971.
 “The validation status of blood biomarkers of amyloid and phospho-tau assessed with the 5-phase development framework for AD biomarkers” European Journal of Nuclear Medicine and Molecular Imaging; Open Access, 06 March 2021. https://link.springer.com/article/10.1007/s00259-021-05253-y
 Alzheimer’s Association, “FDA-approved treatments for Alzheimer’s” https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048103
 FDA, “FDA’s Decision to Approve New Treatment for Alzheimer’s Disease” https://www.fda.gov/drugs/news-events-human-drugs/fdas-decision-approve-new-treatment-alzheimers-disease
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