Newswise — New guidelines call for pathologists to look for possible signs of Alzheimer’s disease in the brains of deceased patients, regardless of whether those patients had had symptoms of dementia in their lives. This means that when a parent or loved one dies, family members may find out for the first time that a relative had telltale signs of Alzheimer’s disease. The recommendations, described this week in Alzforum (www.alzforum.org), mark a change in how experts view and study Alzheimer’s.
Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills. The disease also causes particular changes in the brain, such as the deposition of amyloid protein in clumps or plaques, that pathologists can detect at autopsy. Until now, a doctor would first determine if a patient has signs of dementia and after the patient’s death it was then the pathologist’s job to figure out whether the dementia was due to Alzheimer’s. The new recommendations however say that a pathologist should look for plaques and other hallmarks of Alzheimer’s disease in autopsied brains of people who never showed signs of dementia in life.
These recommendations developed by the National institute on Aging and the Alzheimer’s Association replace guidelines that were put in place in 1997. They reflect a growing realization among researchers that the disease process for Alzheimer’s disease may actually start more than a decade before symptoms of dementia become evident. The new recommendations have not yet been finalized but are expected to be approved this month and published by the new year. In the meantime, Alzforum reports in a two-part article series that draft guidelines have stirred up a fair bit of debate among experts, especially when it comes to deciding which brain changes are important to the disease process, how they should be measured, and how pathologists in different centers and countries can harmonize their work.
The articles are available at http://www.alzforum.org/new/detail.asp?id=2902 andhttp://www.alzforum.org/new/detail.asp?id=2903.
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