If anyone in your family has experienced dementia at a young age (before 65), you and other family members may be at increased risk of developing frontal lobe dementia (FTD) – also known as Pick's disease.
A new blood test may reveal your specific risk.
In 1892, Czechoslovakian neurologist Arnold Pick first documented a type of dementia in which degeneration of cells occurs in the cerebral cortex (the outer layer of the brain) where cognitive and behavioral functions are controlled. Unlike Alzheimer's, Pick's disease is very often diagnosed in patients who are not yet 65.
Studies have shown that certain gene mutations prompt loss of a protein called progranulin (PGRN). When this protein remains low, cerebral cortex cell death occurs.
Researchers at the Flanders Institute for Biotechnology in Belgium devised a blood test that measures blood levels of PGRN. They gave this test a trial in more than 55 subjects – some with gene mutations, some without, some with Pick's disease, some without, and 22 healthy subjects picked at random.
Results were much too complex for you and me (unless you have a deep background in genetics), so I'll let the authors cut straight to their conclusion that appeared in the most recent issue of the Annals of Neurology: "Our results indicate that the serum PGRN level is a reliable biomarker for diagnosing and early detection of frontotemporal lobar degeneration caused by PGRN null mutations."
For those with a family history of Pick's disease, the results of this study will hopefully (and quickly) be confirmed by further research so that a Pick's blood test can be made available to the public.
Beyond this new blood test, I'm afraid there's no good news for Pick's patients. So far there is no cure for the disease, and the survival time from diagnosis averages only about ten years.
But when the symptoms of dementia are first recognized, a conscientious doctor will hold off on moving forward until drug interactions are ruled out.
most doctors would probably rather not admit to: Many adverse conditions prompted by drug interactions mirror symptoms of Alzheimer's and other forms of dementia such as Pick's disease.
"Dr. Jerry Gurwitz, the chief of geriatric medicine at the University of Massachusetts Medical School, says that one of the most valuable lessons he learned from his mentor in medical school was that 'any new symptom in an older person should be considered a drug side effect until proven otherwise.'"
overmedication and misdiagnosis of drug interactions in the elderly might actually be a bigger epidemic than Alzheimer's.
In 2003, the Archives of Internal Medicine published "The Beers list of Potentially Inappropriate Medications in the Elderly."
This is an exhaustive list with dozens of drugs listed. But with new drugs constantly arriving on the marketplace, the list should be considered at least slightly outdated. You can find the list on the website for the Duke Clinical Research Institute (dcri.duke.edu). Use the search engine on the home page to search for "Beers."
DR.W.