Will I have Alzheimer's? Personalized dementia risk assessment now available at UAB
Neurologist David Geldmacher, M.D., who leads the University of Alabama at Birmingham memory disorders program, sees a lot of older patients with memory loss, dementia or Alzheimer's disease.
One of the questions frequently asked of him by the caregivers of these patients, often a spouse or the patients' adult children, is "could this happen to me?"
"It is very common for family members of a patient receiving a diagnosis of Alzheimer's disease or other form of dementia to wonder about their own risk," said Geldmacher, the director of the UAB Division of Memory Disorders and Behavioral Neurology.
Geldmacher is launching a new clinical effort—the first of its type in the United States—to prepare a personalized dementia risk assessment for people concerned about their risk for developing memory problems as they age. The assessment will include family history, a detailed memory history for the patient, cognitive testing and a baseline MRI scan. That information can be incorporated into existing risk predictor models that have been validated by research studies to produce an accurate risk assessment.
Patients will get a comprehensive analysis from Geldmacher, including information on nonmodifiable risk factors such as age and family history, as well as strategies for dealing with modifiable risk factors like weight, diet, blood pressure and level of physical activity. He says research in the field has shown that reducing one or more risk factors can have a significant effect on reducing one's overall chances of developing Alzheimer's disease.
"Our goal is to understand what risk factors are present in each individual and create a plan that best helps them reduce their risk and make appropriate plans for the future," Geldmacher said.
The assessment is targeted primarily at individuals in their 50s and 60s, and it will provide a 20-year risk prediction. It can also be used for individuals in later life, with a six-year risk prediction.
"For most people, Alzheimer's disease is an illness you live with, not an illness from which you die," Geldmacher said. "With a better understanding of individual risk, there are steps that people can take to minimize the risk for serious memory loss."
Patients will have two clinical visits with Geldmacher and his staff. The first will be to compile histories and conduct testing. The second will be to review a personalized treatment plan, including how to access resources to help achieve lifestyle changes, and where to find supportive and educational materials. The clinic will also suggest coping strategies that can be employed to ease the burden of dementia on the individual and his or her family. The two-visit assessment is fee-for-service and will cost about $1,000, which includes the MRI scan.
Geldmacher says this risk assessment service appears to be the first in the nation offered in a clinical setting and not as part of a research study.
"It's really for those who are worried about their cognitive health but do not currently have major memory issues," he said. "People with active memory or cognitive issues that interfere with everyday activities are best cared for through the services of our existing UAB Memory Disorders Clinic."
Geldmacher anticipates that the risk assessment clinic will also ultimately serve as a gateway to research projects aimed at finding medications or other treatments designed to lower risk of memory disorders.