Time to rethink how we diagnose Alzheimer's disease

Alzheimer's disease
PET scan of a human brain with Alzheimer's disease. Credit: public domain

With all the focus on Alzheimer disease in recent years as a result of the aging population, what have we learned? A symposium at The North American Menopause Society (NAMS) Annual Meeting in San Diego, October 3-6, will not only review conflicting evidence regarding the best way to diagnose the disease, but also the latest thinking on the neurodegeneration that often begins during the menopause transition.

The criteria for the diagnosis of dementia due to Alzheimer disease was last updated in 2010. Today, biomarkers (a measurable indicator of the severity or presence of some disease) are often used to help understand the phases of dementia in conjunction with neuropsychological assessments.

Dr. Pauline Maki, a professor of psychiatry, psychology and obstetrics and gynecology, will moderate the symposium at the NAMS 2018 Annual Meeting titled "A Scientific Update on Alzheimer Disease and Women." In addition to summarizing preferred criteria for diagnosing the disease, the symposium will include especially valuable insights for postmenopausal women who, compared to men, are more likely to develop Alzheimer disease during the remainder of their lifetime. It will additionally summarize an impressive body of animal and human research that shows that brain metabolism changes in women after menopause in such a way that it might make them more vulnerable to Alzheimer disease.

"For decades scientists have focused on the amyloid hypothesis of Alzheimer disease, but clinical trials based on that hypothesis have unfortunately failed. There is a new understanding of why biomarkers are important and how they evolve during the course of Alzheimer disease. Scientists are now trying to prevent Alzheimer disease before the memory symptoms appear and are using biomarkers to determine who needs early prevention," says Dr. Maki. "Understanding biomarkers in Alzheimer disease is important because there is roughly a 20-year separation between and Alzheimer, during which time these biomarkers can indicate which women should be targeted for prevention."

"Although Alzheimer is becoming more prevalent as a result of people living longer, it is of particular concern to postmenopausal who, compared to men, are more likely to be affected," says Dr. JoAnn Pinkerton, NAMS executive director. "We look forward to hearing the latest scientific evidence on this critical topic."


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