MY STORY REVISITED #206-MY STORY ON MY STORY
nine years ago i was asked to give an alzheimers talk at a senior expo in the area where i was in practice for 10 years
the talk was well attended
i gave the almost 50 minute presentation then answered questions for probably close to an hour
now when i look at what was on my slides
some things havent changed much
some have
the clinical trials i mentioned have been all completed
the a4 study showed after 10 years that infusions of solanezumab a monoclonal antibody didnt help at all
since then the monoclonal antibodies against amyloid plaques aduhelm leqembi and now donanemab has been approved for use in early alzheimers to slow down symptoms
the colombian study showed that these drugs didnt work in early onset genetic alzheimers disease
the bace inhibitor study showed that bace inhibitors didnt work but actually made things worse
the amyloid pet scan is routinely used now in a workup for alzheimers disease
medicare even pays for it as it also pays for these 3 new drugs
the alzheimers blood test is routinely used in clinical trials and will be coming to your doctors office soon to help diagnose alzheimers
if you look at that amyloid pet scan on the right side thats a positive amyloid pet scan
mine use to look like that in 2015
but
in late 2023 my amyloid pet scan was negative like the one on the left side
who would have hoped for that when i was doing my presentation
the answer
me thats who
__________
09-22-2015
MY STORY
here is a link to information on the senior expo where
i will be doing a presentation on alzheimers disease today
at the bottom of the article is a few paragraphs
about my presentation
senior expo article
below are the slides from the talk
for those not attending
and
for those who did attend
slide 1 is a normal vs an alzheimers brain
total destruction has occurred
the theory is it starts with the bad beta amyloid accumulating then the
tau protein unravels resulting in brain cell death
it all starts in the underneath portion of the brain called the hippocampus
then spreads over the brain
what area of the brain thats affected determines what you see in
your loved ones
slide 2 is information on aricept (donepezil)
slide 3 is a list of tests that someone should have if they have memory loss
the ? ones are now available to private practice but are not paid for by
insurance
the last one the alzheimers blood test should be commercially available soon
its 90% accurate
slide 4 is the labs that are generally done
some providers add the homocysteine level since it may be associated
with an increased risk for alzheimers stroke and heart disease
i would add a ua in the elderly
slide 5 is an mri scan
this one shows a stroke
slide 6 is the new amyvid pet scan that highlights the beta amyloid
that accumulates in the brain
if you have alzheimers this test will be positive
slide 7 is the alzheimers graph that shows when things happen
as alzheimers develops
note that the bad beta amyloid and tau accumulates years before
symptoms develop
slide 8 is a list of things to do to slow down the disease
it is especially important to start as young as possible
slide 9 is a list of treatment research studies ongoing now
hopefully the treatments will be available in 5 years+
slide 10 is a reference list
the clinical best practices is a pdf file from the texas health department
on the recommended evaluation and treatment of memory loss
i look forward to the presentation today
hoping to give answers to those who cant get their questions answered
elsewhere
_________
the evaluation one does for memory loss hasnt changed much in nine years
exam history memory testing labs mri of the brain
now if needed an amyloid pet scan of the brain can be done to see if amyloid plaque is present in the brain
it is the hallmark of alzheimers this amyloid plaque
soon in 2-3 years an alzheimers blood test will be done
if its negative no amyloid scan is needed
if its positive an amyloid scan may be done to verify the diagnosis
then
if the disease is early enough treatment with leqembi or donanemab can be started to maybe slow things down
so we have made progress in the last 9 years
now
we need to make more progress in the next 9 years to treat tau tangles and inflammation in the brain
i wonder what i will be writing about in 9 years
hopefully more successes
the organicgreen doctor
No comments:
Post a Comment