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

Sunday, January 28, 2024

alzheimers news-how to diagnosis and treat alzheimers in the future


this prediction below of how to diagnosis and treat alzheimers disease is based on
from being in alzheimers research studies 
from being treated with the antiamyloid plaque antibody aduhelm or aducanumab 
from reading hundreds of articles on alzheimers 
from attending and presenting at lots of alzheimers programs and seminars
from doing online interviews 
from interacting with numerous neurologists

when i was diagnosed in 2010
i saw a neurologist since my memory test in the adni 2 alzheimers research study was abnormal
i had a thorough neurological history and physical
i had the standard labs like cbc metabolic profile thyroid level vitamin b12 vitamin d3 and homocysteine level
i had an mri done that was normal

initially my diagnosis was based on my memory test and my strong family history of alzheimers
i was placed on aricept or donepezil to slow down symptoms
i have been on that for 13 years

later i had genetic tests that showed i did not have the early onset alzheimers gene
i did have the late onset alzheimers gene called apoe 4
i had the homozygous gene apoe 4 apoe 4 which increased my risk by 10-20 times

i also had a spinal tap for amyloid and tau which showed results compatible with alzheimers
later when i entered the biogen aduhelm treatment study my amyloid pet scan was positive
all these confirmed i had alzheimers 
most folks during that time and even today stop at the mri
there was no treatment back then except for the aricept or donepezil

now in 2024 if i had symptoms i would have the same workup except i wouldnt have the spinal tap
i would still do the genetic testing so my relatives would know its in our family genetically
i would do an amyloid pet scan that would confirm my diagnosis
medicare now pays for it and probably most insurances will eventually
in 2024 i would begin treatment with leqembi with bimonthly infusions for at least 18 months maybe longer
i would be looking around also to find clinical trials that was treating tau tangles in the brain
i would also take aricept or donepezil since the earlier you start the longer it works to slow down symptoms

in the theory of what happens in alzheimers
amyloid plaques develop first
tau tangles then accumulate
inflammation then sets in 
all kill brain cells
the goal is to slow this down

where the tau tangles accumulate in the brain is where alzheimers is active in the brain
the goal in the future is to treat each separately 
like leqembi for amyloid
an antitau drug for tau tangles
an antiinflammatory drug for inflammation

doing all this should slow down the disease
adding of course all the healthy things one should be doing

so if you fast forward to 2030
if you are not having memory issues and have a strong family history of alzheimers you could have
your amyloid checked by a blood test as a screening test and then confirmed with an amyloid pet scan
your tau checked by a new blood test coming soon to screen you
if your memory test is normal and your amyloid and tau are positive 
you might then consider beginning treatment with an antiamyloid drug like leqembi or some newer one maybe a pill to start removing the plaques

this is called prealzheimers ie there is no memory loss but amyloid and tau in the brain are present in the brain

also they probably will be treating folks like this for tau with an antitau drug
the thinking is removing these will slow down or prevent alzheimers from developing

we are actually that close to doing this 
they are already doing it in clinical trials now

when i was in my early 50s when my memory tests would have been normal had it been 2030 i probably would have done all of this had it been available

in 2030 if you have concerns for your memory 
you can do the workup i had in 2010 
then do the ptau blood test

if  positive then you probably have alzheimers and could proceed with an amyloid scan to make a definitive diagnosis 
then you could start with treatment with an antimyloid drug like leqembi and an antitau drug and maybe an antiinflammatory drug and probably aricept

if the blood test is negative you probably dont have alzheimers 

in about 5 years if you have memory issues you can go see your doctor and get an evaluation to include a blood test for amyloid and tau
if the blood test is negative you probably dont have alzheimers
if the blood test is positive you probably have alzheimers and will need more testing
if its alzheimers you will be able to get treatment to slow down the disease 

we are getting there its seems

the organicgreen doctor

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