Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why the expansion of Alzheimer’s may not be helpful

George Lundberg, MD
Conditions
September 22, 2010
Share
Tweet
Share

You probably saw the July press reports: balmy tropical breezes, azure surf, cerebral plaques and tangles, and new criteria for Alzheimer’s.

Who could deny an opportunity to spend some time at the best non-oil-spoiled beaches for those who toil at the benches and bedsides for Alzheimer’s victims — and on taxpayer money yet.

It seems to me like, just as human hip and knee joints and premolars and molars are not preprogrammed to make it much past “three score and 10” for many, and certainly not to “four score and 10” for most, neither is a normally functional brain.

From the recent Aloha State gathering, we learn of a commercial race for tools to diagnose Alzheimer’s early. The current leader seems to be a dye and a PET scan to find amyloid plaques, although other imaging and chemical tests are also competing.

The combo of NIH-sponsored folks and the Alzheimer’s special interest group decided that we in medical science should now consider their new classification of preclinical Alzheimer’s (maybe five years); mild cognitive impairment (maybe another five years) and classical dementia (maybe a third five or more years).

This would triple the number of Americans carrying some kind of Alzheimer’s designation.

Of course, the goal of any medical diagnosis and therapy is, first, to prevent a dread disease from beginning, and, second, to cure or at least manage it once it has begun.

This expansion of the Alzheimer’s reach may be a useful concept as a working hypothesis or as a descriptor of the natural history of a disease. But, what good, pray tell, in our action-oriented society, does this concept do any patient as of 2010, since no diagnostic test (except autopsy) or therapeutic procedure has been shown either to ascertain the certainty of diagnosis or to alter the progression of the disease?

Research is terrific; I want to know truth.

So, go ahead and develop the diagnostic tests and create possible therapeutic agents. Then try the most promising agents in clinical trials to ascertain safety and effectiveness. A drug that either delays the onset of dementia or speeds its progression, once established, could be immensely useful.

But please do not unleash such diagnostic tests for clinical use on the public until we have a way to intervene to positively change prognosis or course of the disease.

I greatly fear that the American Medical Marketing Machine (AMMM) will shift into high gear to make big bucks for the company execs, shareholders, physicians, and labs by testing the masses for Alzheimer’s stages 1, 2, or 3. And this without a proven treatment, to no patient’s benefit, but with grievous harm for many afflicted.

Until or unless there are helpful treatments that the average patient and physician can use in response to any positive lab tests, do not do the tests beyond the research setting.

ADVERTISEMENT

As the Bard so wisely saith, “full of sound and fury, signifying nothing.”

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more neurology news.

Prev

Fact or Fiction: ADHD in America, panelist video interviews

September 22, 2010 Kevin 0
…
Next

How you can avoid skin cancer risk

September 22, 2010 Kevin 0
…

Tagged as: Patients, Primary Care

Post navigation

< Previous Post
Fact or Fiction: ADHD in America, panelist video interviews
Next Post >
How you can avoid skin cancer risk

ADVERTISEMENT

More by George Lundberg, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Pathologists face a stark career choice

    George Lundberg, MD
  • a desk with keyboard and ipad with the kevinmd logo

    A culture of cover-up has slowed the patient safety movement

    George Lundberg, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Do drugs aid and abet genius or does genius lead to drugs?

    George Lundberg, MD

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why the expansion of Alzheimer’s may not be helpful
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...