welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Saturday, August 12, 2023

alzheimers news-new classifications of stages for alzheimers disease


if you look on the alzheimers association website you can find the stages of alzheimers linked here
those stages are good for the general public to look at to see what stage they are or their loved ones are at with their alzheimers disease

now the nia national institutes of aging are proposing new stages along with the alzheimers association
a lot of things have changed in the alzheimers world in the last 5 years

these changes include blood tests memory tests adl or activities of daily living screenings amyloid pet scans tau pet scans and spinal tap results 

these new stages are in draft form linked here
the stages are on pages 10-11

ill try to make it simple
apoe 4 is a gene associated with late onset alzheimers disease
blood tests will show amyloid and tau levels which correlates with amyloid and tau in the brain
amyloid pet scans show amyloid plaques which means a person will probably have alzheimers
tau pet scans will show tau tangles in the brain which shows us where the alzheimers has spread to
spinal fluid for amyloid and tau will tell us if one probably has alzheimers

clinical staging for individuals on the alzheimer’s disease continuum

stage 0 asymptomatic deterministic gene 

memory tests are normal
blood tests spinal fluid amyloid pet scans tau pet scans are normal
these are called biomarkers
apoe 4 gene test is positive 

stage 1 asymptomatic biomarker evidence only

memory tests are all normal
blood tests spinal fluid amyloid pet scans tau pet scans are abnormal

stage 2 transitional decline mild detectable change but minimal impact on daily function

normal memory tests
mild decline in function and mood
biomarkers positive

stage 3 cognitive impairment with early functional impact

increasing functional decline
some memory decline
some adl decline
biomarkers will be positive to the end

stage 4 dementia with mild functional impairment

more decline in memory and functional impairment

stage 5 dementia with moderate functional impairment

moderate functional impairment
more decline in adl

Stage 6 Dementia with severe functional impairment
final stage of alzheimers
severe memory and functional impairment

i expect as time goes on the nia and alzheimers association will make this more regular people usable
it will be used probably a lot in clinical research studies

ill use myself and my family as examples

when i was 50 years old i was in stage 0
my apoe 4 gene test was positive
that puts me at risk for developing late onset alzheimers disease
had i known what i know now i would have gotten more aggressive with my health
controlling my blood pressure with medication
controlling my cholesterol with medication
be active socially physically mentally
maintain my body weight to normal
limit alcohol
get adequate sleep ie 7-8 hrs
avoid stress as much as possible
learn to relax 
consider meditation eg thank you gardening
eat a mind diet

my amyloid tau blood tests spinal tap and amyloid pet scans probably would be normal

as i was nearing 60 before i was diagnosed i was probably in stage 1 i just didnt know it
my biomarkers were probably abnormal but my memory was intact
my guess is when my younger brother was diagnosed with alzheimers disease i probably was in stage 1 already
had it been in 2023 instead of 2010 i would have sought out treatment in one of the new clinical trials for aduhelm or leqembi or donanemab treating those with normal memory but abnormal biomarkers

i think i was between stage 1 and 2 when i was diagnosed
minimal memory testing changes with normal adl functioning
my spinal fluid and amyloid pet scan were abnormal

sometimes i think i have reverted back to stage 1 now
i probably made it to early stage 2 at one point 

if i went in for testing now and no one knew my history i would probably test out stage 1 since my biomarkers are all positive

my younger brother a year younger than me probably was in stage 4 when he was diagnosed
he and my mother died in stage 6

i dont want to go to stage 6
i want to die before i get to that stage to spare myself and my family the grief and suffering

more than likely when the alzheimers association puts these new stages on their website it will be well written in lay terms

its a different world in the alzheimers world now
here is a link to a forbes article about these new stages
what effects it may have on society

i dont totally agree with what they are saying in the forbes article

when you talk about and think about alzheimers think of it as cancer
what workup and treatment is done for folks who have cancer
i hear no complaints about costs and results and risks when they talk about cancer

we as a society need to reassess how we think about alzheimers 

the organicgreen doctor

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