Most of us think the clearest sign of Alzheimer’s is memory loss.
But a new study warns that isn’t the case.
In fact, there are many different kinds of the degenerative disease.
By failing to spot the tell-tale signs, many people are not diagnosed until much later.
And, for the same reason, few people with less obvious signs of the disease are involved in clinical trials.
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By failing to spot the signs, such as difficulty writing, many are not diagnosed until later
The latest research from Northwestern University’s Cognitive Neurology and Alzheimer’s Disease Center is an attempt to change our preconceptions.
‘We wanted to describe these individuals to raise awareness about the early clinical and brain features of PPA [primary progressive aphasia] to develop metrics which would advocate for their inclusion in clinical trials targeting Alzheimer’s disease,’ Dr Emily 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.’
According to Dr Rogalski, your symptoms and kind of Alzheimer’s will depend on what part of the brain is affected.
And a doctor cannot know for sure where a person’s disease is rooted until after their death during a post-mortem examination.
However, there are some key markers of PPA that we may not immediately recognize as symptoms.
First, lack of inhibitions.
This can be the case for many forms of Alzheimer’s, including PPA.
‘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,’ Dr Rogalski said.
This is most clearly seen in patients with PPA.
Primary progressive aphasia is a particular form of dementia that causes declines in our ability to process speech and articulate words.
Patients may have slow or halting speech, decreased vocabulary, and misuse of words (saying ‘pan’ instead of ‘spoon’).
Someone who may have had no issues spelling words may suddenly begin to struggle.
They may also struggle with the physical act of writing, for example writing a check or signing a card.
It can become difficult to follow sentences through to the end, or to digest a full paragraph.
To explore these symptoms more closely, the team at Northwestern monitored a group of people with primary PPA.
PPA can be caused either by Alzheimer’s disease or another neurodegenerative disease family called frontotemporal lobar degeneration.
Alzheimer’s is caused by a build-up of amyloid plaque in the brain (pictured)
The researchers used amyloid PET imaging to determine whether or not Alzheimer’s were the cause of the patients’ PPA.
They then observed all their symptoms in an attempt to map out how the disease manifests itself.
It is an important step, they said, to raising awareness about the different forms Alzheimer’s can take.
However, the signs can still be easily overlooked, and amyloid PET scans are the only sure-fire way of obtaining a diagnosis.
They hope that over time these scans – and other technologies – can be developed to reach more accurate diagnoses.
‘These individuals are often overlooked in clinical trial designs and are missing out on opportunities to participate in clinical trials to treat Alzheimer’s,’ Dr Rogalski said.