The importance of an early Alzheimer's diagnosis
In this blog post Chris Williams, epidemiologist and founder of Tiggo Care, explains why it’s important to diagnose Alzheimer's early for the benefit of patients, caregivers, and researchers.
This guest blog post is written by Chris Williams, an epidemiologist and founder of Tiggo Care, an award-winning home care agency based in London, UK.
Dementia affects millions of people worldwide, and it is estimated that over 850,000 people in the UK live with dementia. Dementia is a term used to describe a group of symptoms that affect memory, thinking, and social abilities. Alzheimer's Disease, which is the focus of this blog post, is the most common type of dementia and is characterised by the following symptoms:
Difficulty with familiar tasks
Disorientation and confusion
Difficulty with problem-solving and decision-making
Difficulty with self-care
If you think a loved one has dementia it's important to get a proper diagnosis from a doctor so the patient and their caregivers can receive professional advice and support. Earlier diagnoses have more benefits than later diagnoses and this blog post will highlight some of the benefits an early diagnosis can afford patients, caregivers, and clinical researchers.
Benefits for Patients
Improved Health Outcomes
Current treatments for Alzheimer's disease, such as acetylcholinesterase inhibitors and memantine, do not cure the condition but can help slow the progression of the disease. Additional treatments, Leqembi and Aduhelm, received partial approval from the United States’ FDA in 2021 and 2023 and are currently under review for full approval. Receiving an early diagnosis will ensure that the patient is prescribed these medications as soon as possible and that they receive the maximum possible benefit from these treatments.
The patient's consultant or GP might also recommend non-pharmacological treatments to help slow the progression of Alzheimer’s disease. For example, in cognitive stimulation therapy, patients participate in group exercises designed to improve memory and problem-solving skills. Starting these types of therapies early can delay the need to start taking medications that can have unwanted side effects.
Patients often forget that lifestyle factors also influence the progression of the disease and when they receive an official diagnosis their doctor might recommend they make some lifestyle changes to slow the progression of the disease. For example, stopping smoking, exercising, lowering your blood pressure, and staying mentally and socially active can all help to slow cognitive decline.
Psychological and Emotional Support
Symptoms associated with cognitive decline can be confusing for patients and it’s not uncommon for patients to feel anxious. Receiving an early diagnosis can help reduce those anxieties as patients will have a better understanding of why they’re experiencing those symptoms. Patients will also have more time to spend with their families and access support.
Future planning goes beyond making a Will where an individual outlines what will happen to their personal belongings after their death. Patients should consider making advanced decisions, also known as living wills, and registering a Lasting Power of Attorney, which is a document where they formally designate a person to make decisions on their behalf if they’re unable to due to a lack of mental capacity. These are legal documents and to officially register them patients must have full mental capacity. Receiving an early Alzheimer’s diagnosis gives patients plenty of time to think about the future and ensures they don’t have to make rushed decisions or miss out on the opportunity to make these decisions altogether.
An early Alzheimer’s diagnosis also gives the patient and their family time to plan for the costs associated with dementia care. Dementia care can be expensive and currently, there is little government funding available in the United Kingdom or the United States. Tiggo Care has written a complete Guide to Care Funding Options that readers exploring funding options in the UK might find useful.
Benefits for Caregivers
Improved Care Planning
Knowing that an individual has an early Alzheimer’s diagnosis makes it much easier to organise appropriate care. For example, the early diagnosis gives the patient and their family time to decide if they want to organise a live-in care service sooner rather than later, such that the patient can build a professional relationship with a live-in carer while they still have good cognitive function. Alternatively, the patient and their family may decide to use a specialist dementia home care service or look for a room at a specialist dementia care facility. The early diagnosis makes it easier for the patient to be involved in these decisions and can alleviate any stress resulting from changes to their daily routine.
An early diagnosis makes it easier for caregivers to encourage patients to adopt healthy behaviours, such as healthy diets and regular exercise, to slow the onset of dementia symptoms. Caregivers can also encourage patients to stay mentally active by completing puzzles and jigsaws, or even escort them on trips in the community to ensure they remain socially active. At later stages, caregivers may struggle to encourage patients to make these beneficial lifestyle changes.
In most cases, patients will need to make some adaptations to their homes to ensure that they can continue to live safely at home. An occupational therapist will advise the patient on the specific adaptations and equipment best suited to their specific needs. An early diagnosis allows patients to make these changes ahead of time before an accident happens. It also allows the billpayer to spread the cost of these adaptations over a longer period of time.
Benefits for Researchers
Participant Selection & Evaluation of Early Therapeutic Interventions
Early diagnoses ensure researchers can include individuals in the earliest stages of Alzheimer's disease in their studies, allowing them to identify potential biomarkers and underlying mechanisms from the earliest detectable changes. Ultimately this allows researchers to study the effectiveness of early interventions and early treatments to slow the progression of the disease and potentially even find a cure for the disease.
Identification of Risk Factors
Early diagnosis contributes to the identification of risk factors and the development of early detection methods for Alzheimer’s disease. By studying patients with an early diagnosis, researchers can examine genetic, environmental, and lifestyle factors associated with the disease’s onset. The findings of these research studies can be used to help those most at risk modify their behaviours and environment to reduce their chances of developing or accelerating the symptoms of Alzheimer’s disease.
Understanding Disease Progression
The later stages of Alzheimer’s disease progression are better understood than the early stages of the disease. Earlier diagnoses allow researchers to study the sequence of changes that occur in the brain and body at the onset of the disease. This knowledge helps researchers understand the underlying mechanisms, identify potential targets for intervention, and develop strategies to accurately predict disease progression. It also contributes to the development of staging systems for clinical trials and individualised clinical care planning.
Receiving an early Alzheimer's diagnosis has significant benefits for patients, caregivers, and researchers alike. For patients, early diagnosis can improve health outcomes through timely access to medications and other non-pharmacological treatments, as well as the opportunity to make lifestyle changes that can slow cognitive decline. Caregivers benefit from improved care planning, enabling them to establish support systems and implement safety measures. For researchers, using patients in their studies with very early-onset Alzheimer's disease allows for the evaluation of earlier therapeutic interventions and greater insight into associated risk factors. Ultimately, early diagnosis plays a pivotal role in enhancing care, improving outcomes, and advancing research efforts in the fight against Alzheimer's disease.