ALZHEIMERS NEWS-THERE ARENT ENOUGH ALZHEIMERS SPECIALISTS
what are alzheimers specialists
they are neurologists
geriatricians
geriatric psychiatrists
there is a limited supply of these alzheimers specialists in the united states
there are now over 6 million plus folks with alzheimers disease
that doesnt even count those folks who will be diagnosed earlier than ever before
many with mci or mild cognitive impairment due to alzheimers with be diagnosed early with the emphasis now on early diagnosis
this will produce a lot of folks needing to see these alzheimers specialists
however
there arent enough of them
i predict that soon there will be a lot of testing in the primary care doctors office and probably in those do it yourself testing sites that will be doing these new testings for biomarkers in the blood that will tell you if you have the positive biomarkers for alzheimers meaning you will likely develop full blown alzheimers one day
as a review
in the development of alzheimers as the amyloid accumulates and the tau tangles start forming and as inflammation starts you will soon be able to measure that in the blood
the stages as alzheimers develops are
prealzheimers or prodromal alzheimers where there is no memory loss but these blood biomarkers will be positive
there are millions of these folks that will be diagnosed
mci or mild cognitive impairment due to alzheimers disease
these patients like me have mild memory issues with positive blood biomarkers
early alzheimers
these patients have more advanced memory loss with the positive blood biomarkers
middle or mid alzheimers
these folks are early alzheimers patients who have developed worsening memory and other neurological problems
late alzheimers
these alzheimers patients are advancing into the later and the downward course of the disease
the final step is death
who is going to diagnose and treat these patients
there arent enough alzheimers specialists
eg
i make my neurology appointments a year in advance and dont dare try to change it
they are hard to come by
the only solution i see
is
the primary care physician
i understand its hard to have a lot of dementia or alzheimers patients in your practice
a busy family practice
i think if i was in practice now i could accurately evaluate diagnose and treat most alzheimers patients
the secret is to make an accurate diagnosis
this is so much easier to do then it was a few years ago
add the new blood biomarkers and the pet scans for amyloid then its easier to diagnose these memory patients
you could save the alzheimers specialists for the more difficult patients
we do this now with heart disease hard to control hypertension hard to control diabetes hard to control lung disease hard to control depression and anxiety hard to control cholesterol to name a few diseases
eg i use to take care of a lot of childhood asthmatics and think i did a good job of managing their asthma
but
sometimes these patients reached a point where they needed a pulmonary specialists to manage their asthma
however
when i was in practice i wasnt good at taking care of alzheimers patients
i tended to refer them to neurologists for evaluation and treatment
if they werent too complicated many times the patient would return to me for medication management
ie aricept or donepezil
i might do some lab work but didnt really do much else except for ruling out abnormal labs and maybe doing a quicky clock memory test
i really did not know as much as i do now about alzheimers disease and its management
i began to learn more when my mom was diagnosed and later when my younger brother was diagnosed
that happened in the last years of my practice
it was after i was diagnosed with mci due to alzheimers disease
i began reading a lot more about alzheimers disease got involved in clinical trials and began doing alzheimers talks to groups
i began following the research and will read several articles on alzheimers disease each day
eg
i read 10 articles this morning on alzheimers disease and read through two new clinical trials that are starting up
so
today if i was in practice i would do like i did with my asthmatic patients
i would diagnose and manage most of them myself
seeking out alzheimers specialists whenever i needed help with diagnosing or management of a patient
i would be able to take care of the majority of these patents and diagnose them with a high degree of accuracy
thats the solution here
is to train primary care providers to do what i would do if i was in practice
it could be done with educational outreach programs to retrain primary care providers to do more of the work and do it accurately
here is a link to an article i read about this today that sparked me writing this blog
its a review from the 2022 dementia fact figures report from the alzheimers associations
the solution is not training more alzheimers specialists since that will take years to do
the solution is to educate our primary care providers
they need a cookbook of alzheimers management
a simple straight forward easy to follow guide
there arent enough alzheimers specialists to take care of the millions that are going to be diagnosed in the future
the organicgreen doctor
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