Is there an early diagnosis of possible dementias?

Is there an early diagnosis of possible dementias?

The 5th edition of the Jornada Paulista da Alzheimer’s Disease aims to highlight the need for an early diagnosis in order to establish new criteria in the treatment. Science has already concluded that neurodegenerative processes can start up to two decades before the first clinical manifestations such as Alzheimer’s disease. Sometimes they begin to manifest with symptoms other than classic memory difficulties.

With the theme ‘Early Diagnosis – New Frontiers, New Possibilities’, the Brazilian Alzheimer’s Association – São Paulo Regional (ABRAz-SP) takes on the role of bringing new knowledge about dementia to the center of the discussion. The 5th São Paulo Conference on Alzheimer’s Disease seeks to provide comprehensive and free information to health professionals, family members and caregivers of patients with dementia. “We will bring to the fore all aspects of diagnosis, more specifically early diagnosis, addressing the concepts, tests, the challenges of the current scenario”, says the president of ABRAz-SP and geriatrician, Celene Queiroz Pinheiro de Oliveira.

The president of ABRAz-SP and geriatrician, Celene Queiroz Pinheiro de Oliveira – Credit: Sacha Ueda

As a result of an early diagnosis, progress in understanding and dealing with the disease has gained new contours. As the patient still preserves the cognition and understanding of the disease, questions about the treatment become relevant. “In these cases, the patient cannot be treated as an adjunct by the family or justice. He has autonomy for decisions about his own future”, says Celene.

Event

The journey, which will take place on September 17, Saturday, from 8 am to 12 pm, in online format, will be divided into two rooms with lectures. The interdisciplinary room will address ethical aspects when presenting the diagnosis to the patient and family and also the most appropriate way to plan treatment, considering legal, labor, financial and emotional issues. The exclusive room for doctors will bring innovations and scientific knowledge – the result of studies and research to understand how Alzheimer’s disease develops. The inaugural class will bring concepts about: how, when and why the early diagnosis of Alzheimer’s Disease is sought with the American neurologist, Kirk Daffner, from the Boston Neuroscience Center (MA), author of books such as Improving Memory: Understanding Age-related Memory Loss.

The question: “Cognition or behavior? What are the initial symptoms of Alzheimer’s disease” will be the topic that the neurologist, Fabricio Ferreira de Oliveira, will discuss with the participants in the event.

‘The barriers to early diagnosis in Brazil’ will be the theme that the neurologist, professor at the Faculty of Medicine of UFMG and coordinator of the Advisory Board of ISTAART |(The Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment), Paulo Caramelli , will address in the third lecture of the day.

Doctors Artur Coutinho (specialist in nuclear medicine) and Lucas Francisco Botequio Mella (psychiatrist) will clarify the importance of identifiable biomarker data in imaging and blood tests in diagnostic investigation.

Closing the activities in the doctors’ room, the lecture ‘Psychological aspects of early diagnosis’, with the psychologist and former president of ABRAz, Fernanda Gouveia, who will discuss the positive and negative points of early diagnosis such as acceptance and the psychological suffering to which the patient and family are exposed.

The Journey will also bring ethical issues that involve the doctor, patient and family, such as: the disclosure of the diagnosis: for the patient or just for the family?, how to inform clearly without alarmism and prejudice. “With early diagnosis, the patient becomes the protagonist, how he wants his treatment to be done, how he wants his financial life to be conducted, legal issues of inheritance, and everyday details can be thought about while there is cognition”, he says. Celene.

The complete schedule can be accessed here with the details of each lecture and speaker and registrations can be made through this channel.

The Beginnings of Alzheimer’s Disease

The first signs of Alzheimer’s disease and other neurodegenerative pathologies can be changes in behavior or mood disorders. “Knowing better the trademarks (biomarkers) of these diseases and based on them new diagnostic criteria were established”, says the neurologist and scientific director of ABRAz-SP, Fábio Henrique de Gobbi Porto.

The neurologist and scientific director of ABRAz-SP, Fábio Henrique de Gobbi Porto – Credit: Personal archive

He explains that the deposition of specific proteins such as β-amyloid and tau can be noticed in brain tissue through scintigraphy exams, the same proteins can be measured in CSF and other fluids such as blood and saliva. “The action of depositing these proteins in brain tissue leads to atrophy of certain brain areas and are detected in imaging tests such as resonance.”

medication

Based on new diagnostic concepts, new drugs began to be developed and for the first time aimed at preventing or containing the processes responsible for neurodegeneration.

The first drug with modifying action against Alzheimer’s disease, aducanumab, was approved on an emergency basis by the FDA (US agency that regulates drugs and food), under great controversy. In Brazil, ANVISA barred the arrival of the medication earlier this year. “However, many others are in the process of having their studies published and will promptly be submitted for analysis by the competent bodies”, says Celene.

Law Suit

The vice-president of ABRAz-SP, geriatrician Jean Pierre de Alencar, points out that there is a hunger for better solutions in relation to dementia, as the last launch for the treatment of Alzheimer’s disease is over 20 years old.

The vice president of ABRAz-SP, the geriatric doctor Jean Pierre de Alencar – Credit: Personal archive

It contrasts with the time of study of Alzheimer’s for new drugs and solutions, the estimates with the incidence of the disease in the world. The conditions are alarming. Estimates make it possible to have around 50 million people affected in the world, with prospects of tripling by 2050”, reports Jean Pierre.

Data from the Alzheimer’s Disease International (ADI) report point out that Alzheimer’s represents the seventh leading cause of mortality globally and one of the longest and most costly. “And most worryingly, these numbers tend to be even higher in countries with low socioeconomic development” says Jean Pierre.

The ADI estimates that only 25% of dementia cases are diagnosed. In low-developing countries, the number represents less than 10%, showing the importance of talking about the subject and alerting the population, as data from the same report show that two in three people still believe that cognitive decline is a natural result of aging – the same among health professionals.

About ABRAz

ABRAz – Brazilian Alzheimer’s Association – is a member of a network of people and national and international organizations formed by 132 countries, which are affiliated to ADI (Alzheimer’s Disease International), all involved with Alzheimer’s Disease. The mission is to provide social, emotional and informational support to family members; promotion of cognitive and social stimulation to patients; production and dissemination of knowledge about Alzheimer’s Disease and other dementias and also articulation with agents that promote actions for the benefit of patients and caregivers.

Free and universal, ABRAz has national representation in welcoming and supporting families affected by dementia and is recognized as a transforming agent in eliminating the stigma associated with the disease and improving the quality of life of all those involved in the process.

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