RLearn about Alzheimer’s and other forms of dementia thanks to a guide that indicates the tests to undergo, based on the mode of presentation of symptoms. These are the first ones recommendations approved and shared by experts from the major European scientific societies to identify a precise diagnostic path in four successive steps and unravel the many causes of dementia.
Alzheimer’s and cognitive disorders: a new diagnostic approach
Thanks to new guide completely changes the diagnostic approach. The first European inter-society recommendations, created by experts from the major scientific societies in the sector and coordinated by specialists in theUniversity of GenoaIRCCS San Martino Polyclinic Hospitalof theUniversity of Genevaeof theIRCCS Saint John of God Fatebenefratelli Center of Bresciawill allow you to be able to give a name to the problem of those who show the first signs of cognitive deterioration sooner and betterrecognizing whether it is Alzheimer’s, as happens in one case out of two, or another form of dementia.
Focus on the patient
The recommendations have just been published in the prestigious journal The Lancet Neurology. For the first time they are not centered on the disease, but on the patient and his symptoms. Starting from 11 different ways in which the signs appear of cognitive impairment, in 4 next steps and with different tests depending on the profile of the individual patient, it will now be possible to arrive at identify the responsible pathology more quickly and with less waste of resources. «These recommendations arise from the need to have shared, international and well-documented indications but above all centered on the clinical presentation of the symptoms, on the patient rather than on the disease», explains the Professor Flavio Nobili, co-coordinator of the study and Professor of Neurology at the University of Genoa, IRCCS Policlinico San Martino Hospital.
Approach the symptom, not the disease
«The patient with a initial cognitive deficit has about a 50% chance of having Alzheimer’s or another of the various pathologies that cause neurocognitive disorders. To untangle the many causes and arrive at a diagnosis, in addition to cognitive tests today there are many instrumental tests, from CT scans to magnetic resonance imaging to CSF examinations, the cerebrospinal fluid. For each method there are guidelines and areas of application depending on the different diseases. But when the neurologist sees the patient for the first time he still doesn’t know what pathology he suffers from, so it is difficult to use guidelines designed to identify one pathology or the other. That’s why we needed to build recommendations based mainly ‘on the symptom’ and not on the disease» continues Professor Nobili.
Personalized exams
«These recommendations help generate a hypothesis of disease probability it’s at then subject the patient to a logical flow of tests, choosing the most appropriate ones among the many available and then deciding, based on the results, whether to stop or continue with further tests, until a diagnosis with reasonable certainty has been reached. Follow a single diagnostic path that is the same for everyone can be ineffective, imprecise and expensive. Doing all the tests available to all patients is not alone unsustainable from an economic point of view for the Healthcare System, but also goes against the protection of the patient who would thus be exposed to excess radiation and all the risks associated with each procedure. There are dozens of diseases that present with cognitive deficits, although Alzheimer’s is the most frequent cause: having a path to move towards the right diagnosis quickly and economically is essential”, adds the Doctor Federico Massaco-author of the study and researcher at the University of Genoa – IRCCS Ospedale Policlinico San Martino.
The future approach
«Thanks to these recommendations land people with memory disorders will have a diagnosis harmonized and of high quality in every center of Europe. The recommendations we have developed may also be forthcoming updated for the use of Alzheimer’s markers in blood which will shortly be able to be used clinically. All this will allow intercept patients with Alzheimer’s disease at the most suitable time. In the not too distant future we will be able to direct them to therapy with monoclonal antibodies which we hope will arrive in Europe soon. These drugs, if administered to the right patients in an early stage of the disease, can in fact delay memory loss”, concludes the Professor Giovanni Frisonistudy coordinator, Director of the Memory Center and Professor of Neurology at University Hospitals and the University of Geneva.
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