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Welcome to the Dickerson Lab: Spinal fluid testing for diagnosis of AD

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In August 2010, a team of researchers published a new study demonstrating the value of a test of spinal fluid proteins for use as part of the diagnosis of Alzheimer's disease. It is important to clarify that this is confirmation in one of the largest groups of participants to date of work that has been going on for more than 10 years to use measures of several proteins in spinal fluid that are typically deposited in the brain in AD and are visible under the microscope after death. The goal has been to determine how good these spinal fluid measures are in living people for assisting in making a diagnosis of AD. It is very important to note that this is currently being done in patients with dementia and cognitive impairment by many of us as part of the evaluation that leads to a diagnosis. It is not a screening test for use in people who do not have symptoms.

I was interviewed on NECN TV on August 11 regarding this new research, which is important but is being misinterpreted by some of the stories in the media. I strongly recommend that individuals or family members who are concerned about memory or cognitive impairment seek an evaluation by an Alzheimer's or memory specialist, since there are many possible causes for these problems and they deserve full medical evaluation. For people who do not have symptoms but who are concerned about their possible risk, I recommend volunteering for research on memory and aging (most major cities have centers where studies are being conducted, see the Alzheimer's Association website for more information), and encourage increased funding for the research that needs to be conducted in order to better understand what it might mean if a cognitively normal individual has abnormalities suggestive of AD in their brain or spinal fluid, which is at present a research question. Although AD is an common and devastating disease that is a major cause of disability and death around the world, we know that it may take at least a decade or more to develop in the brain before a person has symptoms, and we really don't know how long a person might be able to live independently without symptoms despite having Alzheimer brain changes, or what factors might influence how long such a "silent" stage might be present. We do know that there are many individuals who die with AD in the brain but who do not have cognitive impairment or dementia.

This report is closely related to the newly proposed diagnostic criteria for AD; more can be read about that here.

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