How Do Brain Scans Help Diagnose Alzheimer’s Disease Sooner? And Find Clues About Treatments or Cures?

Alzheimer’s disease is one of the most feared and devastating illnesses we face. The prospect of forgetting our most cherished memories—wedding days, the birth of our children, the faces of our loved ones—is terrifying. So many people believe there is nothing that can be done to avoid this dreaded form of dementia. But what if there was an early detection system that could warn you of potential memory problems decades before you started noticing any symptoms? Such a system already exists—functional brain SPECT imaging. In 2021, the Canadian Association of Nuclear Medicine unanimously endorsed the use of SPECT for the assessment of suspected dementias, including Alzheimer’s disease, frontal temporal lobe dementia, vascular dementia, and mild cognitive impairment. What if there was an early detection system that could warn you of potential memory problems decades before you started noticing any symptoms? Such a system already exists—functional brain SPECT imaging.

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WHAT IS ALZHEIMER’S DISEASE?

Alzheimer’s disease is a neurodegenerative disease that impacts a person’s memory and cognitive abilities and interferes with daily living. Alzheimer’s is the most common form of dementia, an umbrella term for a variety of degenerative brain diseases that impact cognition and memory. Over 6 million Americans over the age of 65 are living with Alzheimer’s disease. By 2050, an estimated 12.7 million seniors over 65 are expected to have Alzheimer’s. Tens of millions more will experience other forms of dementia, and research shows that 75% percent of older adults say they have memory problems. Sadly, the search for a cure in pill form has proved unsuccessful as over 200 medication trials have failed to reverse Alzheimer’s disease and other forms of dementia.  Given the complexity of the illness and how early it starts in the brain, we are likely never going to have a single medicine that cures these illnesses. If you are fortunate enough to live until age 85 you have a frightening 50% chance of being diagnosed with Alzheimer’s disease or another form of dementia. And these illnesses start ravaging the brain years before you have any symptoms.

THE OLD WAY OF DIAGNOSING ALZHEIMER’S DISEASE

The typical way people get diagnosed with Alzheimer’s disease and other dementias is woefully inadequate. It usually involves a brief visit to a primary care physician or local neurologist, who asks a few questions, gives some short tests, orders an MRI (which looks at the structure of the brain), and says, “Everyone has memory problems with age. You’re normal.” At this stage, people are often diagnosed with mild cognitive impairment (MCI) or early Alzheimer’s. People may be encouraged to get advanced health directives, power of attorney documents, and financial affairs in order. A memory medication called Aricept, which has short-term benefits but loses its effectiveness after 18 months, is commonly prescribed. A follow-up appointment may be recommended in six months. In 80-90% of the people who visit Amen Clinics after going through the traditional medical system for memory problems, that is the extent of the evaluation. It’s completely ineffective, heartbreaking, and unconscionable given what we know now.

BRAIN IMAGING AND ALZHEIMER’S DISEASE

Brain imaging is used regularly in the diagnosis of Alzheimer’s, and based on brain imaging data, the National Institute on Aging (NIA) revised its staging guidelines for Alzheimer’s disease in 2011. The old guidelines had 3 stages:

1. Normal: no symptoms
2. Mild cognitive impairment: people or relatives have started to notice a problem
3. Alzheimer’s disease: a significant problem is present and getting worse.

Based on new brain imaging data, the NIA added a fourth stage.

1. Normal
2. Preclinical: no obvious symptoms, but negative changes can be seen on brain scan
3. Mild cognitive impairment
4. Alzheimer’s disease

The “preclinical” stage indicates that although you may not have any noticeable symptoms, your brain may already be deteriorating. Brain imaging can help detect early changes in the brain associated with Alzheimer’s disease. There are several ways to look at your brain if you are concerned about your memory. Structural brain imaging studies: Most physicians will order an imaging study, such as an MRI (magnetic resonance imaging) or CT (computerized axial tomography) scan, that looks at the structural integrity of the brain. Most of these studies come back as normal, or as “mild atrophy (shrinkage) consistent with aging,” which is not very helpful. These types of scans can help rule out other possible causes of Alzheimer’s-like symptoms, such as a brain tumor or stroke. They also show brain changes that occur later in the course of the illness when interventions tend to be less effective. Functional brain imaging studies: Some neuroimaging studies—including SPECT (single-photon emission computerized tomography), PET (positron emission tomography), or QEEG (quantitative electroencephalogram)—look at how the brain is working. They are more useful because functional problems almost always precede structural ones. Functional studies are leading indicators of problems, meaning they show evidence of the disease process years before people show signs of it. Note that due to cost, PET scans are not commonly used. SPECT looks at blood flow and activity patterns and reveals areas of the brain with healthy activity, underactivity, or overactivity. On SPECT, low blood flow is the number-one predictive sign of future trouble and Alzheimer’s disease. Unlike MRI and CT, SPECT typically shows problems earlier before symptoms occur, which is when treatment is most likely to be helpful.

HOW BRAIN SCANS IMPROVE ALZHEIMER’S TREATMENT

Early detection in any chronic or progressive disease allows for early intervention when it is likely to be most beneficial. Considering that emerging research shows that Alzheimer’s is a lifestyle disease, similar to diabetes or heart disease, early detection with brain imaging can be life-changing. If Alzheimer’s-like changes are seen on brain scans, taking action by adopting healthier habits as soon as possible may delay or prevent the development of the disease. In some people, slowing the progress may mean completely avoiding the onset of symptoms. If you want to prevent memory problems or rescue your brain if it is headed for trouble, take charge of your brain health now by incorporating 11 proven ways to reduce the risk of Alzheimer’s disease and other dementias. If you’re already experiencing memory loss or other cognitive problems, consider a comprehensive Memory Rescue Program to find targeted solutions for your needs. Memory problems and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.