Early diagnosis and treatment of Alzheimer's disease

Early diagnosis and treatment of Alzheimer’s disease are critical to managing cognitive decline, according to Dr. Nicholas Milano, a neurologist and Director of the South Carolina Alzheimer’s Network (SCAN) at the Medical University of South Carolina. With approximately 11.5% of South Carolinians over age 65 living with Alzheimer’s or related dementias, medical professionals emphasize that identifying the root cause of memory symptoms is the first step in effective clinical care.

Did You Know? Not all memory impairment is caused by Alzheimer’s disease; other factors such as vascular disease, sleep apnea, alcohol use, and certain over-the-counter sleep medications can produce similar cognitive symptoms.

Why Early Diagnosis Matters

Medical intervention is most effective when started in the early stages of the disease. Dr. Milano notes that clinical evidence supports the use of specific medications for Alzheimer’s that perform better when administered early. Furthermore, a formal diagnosis allows clinicians to rule out other, potentially reversible conditions that mimic dementia symptoms, ensuring patients receive the correct treatment for their specific health issues.

The Diagnostic Process

Accurate diagnosis requires a multifaceted approach rather than a single test. According to Dr. Milano, physicians must conduct a thorough neurologic history and physical examination, supplemented by objective cognitive testing. While specialized brain scans, such as MRIs, and emerging blood tests are valuable tools, they are used as part of a broader clinical assessment to confirm an Alzheimer’s diagnosis.

Expert Insight: The integration of eConsult models reflects a strategic shift in managing chronic neurological conditions. By leveraging remote expertise, primary care providers are better equipped to navigate the complexities of early-stage diagnosis, potentially shortening the time between the onset of symptoms and the initiation of evidence-based care.

Addressing the Specialist Shortage

The South Carolina Alzheimer’s Network (SCAN) was established to bridge the gap between primary care providers and neurology specialists. Because there are not enough neurologists to meet the demand for direct patient care, SCAN utilizes an eConsult model. In this system, primary care physicians perform the initial evaluation and share patient charts and imaging with specialists at the Medical University of South Carolina. Specialists then provide remote guidance or arrange for in-person consultations as needed.

Alzheimer's Disease Series: The Value of Early Diagnosis and Treatment of Alzheimer's

What May Happen Next

As research continues, the landscape of Alzheimer’s treatment could shift further. Currently, medications such as lecanemab and donanemab are available to help slow the progression of the disease. It is likely that clinical experts will continue to refine the criteria for these treatments, as they are not suitable for every patient. Patients should expect that continued expert evaluation will remain necessary to determine the appropriateness of these and any future therapies as they enter the market.

Frequently Asked Questions

What conditions can mimic Alzheimer’s symptoms?
Memory issues and cognitive decline can be caused by vascular disease, sleep apnea, alcohol consumption, and certain over-the-counter sleep medications.

How does the SCAN eConsult model work?
Primary care providers perform the initial patient evaluation and submit the patient’s chart and imaging to neurologists. Specialists then review the documentation to provide remote guidance or schedule an in-person visit.

Are there new treatments available for Alzheimer’s?
Yes, two medications, lecanemab and donanemab, have been introduced over the last two to three years and have been shown to slow the progression of the disease.

How might increased access to specialist consultation change the way your primary care physician manages long-term cognitive health?