[헬스코리아뉴스 / 이충만] Since the approval of the monumental Alzheimer’s fundamental treatment ‘Lequembi (ingredient name: lecanemab)’ earlier this year, the approach to dementia has become more systematic.
Dr. Clifford Jack of the Mayo Clinic in the US and his research team presented a new guideline for diagnosing Alzheimer’s at the International Alzheimer’s Association (AAIC) held in the Netherlands on the 16th (local time). This standard is expected to be able to systematically diagnose dementia just like cancer or cardiovascular disease.
Currently, Alzheimer’s disease is diagnosed at the discretion of medical personnel without uniform criteria such as medical history, physical examination and neurological examination, mental status examination, daily living function level examination, laboratory tests such as blood tests, brain imaging examination, and neuropsychological examination.
In particular, the most recently established 2018 Alzheimer’s diagnosis guidelines have been criticized for their poor accessibility. The diagnosis involved brain quantum emission tomography (PET) and collection of cerebral spinal fluid through the spinal cord to test for Alzheimer’s-onset proteins. Although this method increases the accuracy of diagnosis, it is expensive and has not been frequently used in clinical settings.
The proposed guidelines further systematize the diagnosis, quantifying the level of Alzheimer’s disease through measurement tools similar to those used to diagnose cancer. It was designed to exclude the use of vague terms such as mild, moderate, and severe.
Specifically, patients are marked with a score of 1 to 7 depending on the presence or absence of disease biomarkers and cognitive changes, and these are classified into a total of 4 stages of disease grade. For example, stage 1a refers to a stage in which there are no symptoms at all, but markers of Alzheimer’s disease are found. Dr. Clifford Jack said, “Stage 1a is the stage at which the onset of dementia can be officially recognized.”
In stage 2, depending on the measurement tool, Alzheimer’s biomarkers and substantive changes in cognition or behavior are found. Stage 3 corresponds to the presymptomatic stage known as mild cognitive impairment. Stage 4 refers to Alzheimer’s when the symptoms are fully manifested. Scores of 4, 5, and 6 to 7 correspond to the current classification of Alzheimer’s: mild, moderate, and severe, respectively.
When compared 1:1 with a cancer index measuring tool that measures cancer progression, the similarity is even more striking. In the case of cancer, stage 1 is a state in which the cancer is confined to a small area and has not spread to lymph nodes or other tissues, stage 2 is a situation where the cancer has grown but has not metastasized, and stage 3 is a situation where the cancer has grown and has spread to lymph nodes or other tissues. Stage 4 means that the cancer has spread to other organs or parts of the body.
The new guideline establishes a zero period for patients with potential Alzheimer’s disease genes. This category includes people with Down syndrome.
For reference, although Alzheimer’s and Down’s syndrome are different diseases, research has confirmed that the tangle of tau protein, which is responsible for the aggregation of beta-amyloid and the transmission of substances in the nervous system, acts the same biologically on the chromosomes that cause Down syndrome. It is known that about 25% of Down syndrome patients over the age of 40 develop Alzheimer’s disease.
“As cutting-edge technology advances, we are entering an era of much more personalized medicine,” said Maria Carrillo, Chief Scientific Officer of AAIC. I’m starting to understand,” he said.
An AAIC spokesperson said on the same day that the draft guidelines are open for expert review and opinion gathering, and plans to be revised to reflect those opinions later.
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2023-07-17 22:24:55
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