The Future of Diagnosis of Alzheimers Disease

With an expenditure that currently exceeds oncological and cerebrovascular pathology together, and an exponential increase in the number of cases, dementias are the main challenge facing our socio-health systems. Although we do not yet have treatments that modify the course of these diseases in the last decade, there has been much progress in its diagnosis.
Until recently we could only diagnose Alzheimer's disease – the most frequent cause of dementia – when the patient lost his autonomy for the activities of daily living. However, we are currently able to identify those individuals who are at high risk, or who are in very early stages of the disease – in which the patient still retains all of his autonomy. This will allow us in the future to apply therapies very early or even in asymptomatic individuals who already present the pathological changes of Alzheimer's in their brain. Analogous to decreasing cholesterol levels to prevent myocardial infarction or strokes, we may consider decreasing the brain stores of Alzheimer's associated proteins to delay or prevent their onset. For this to be possible, it is necessary to have tests that very reliably allow to estimate the individual risk of developing Alzheimer's.
In the editorial comment published online in the prestigious journal Neurology (https://www.ncbi.nlm.nih.gov/pubmed/28794255), Dr. Pascual Sánchez-Juan (Cognitive  deterioration Unit of the Hospital Marqués de Valdecilla together With Dr. Sudha Seshadri – director of the neurology line of the world's leading epidemiological study – the Framingham Study – discuss the progress of sequential studies of quantification of cerebral amyloid by PET and how the generalization of this methodology, together with Other clinical and genetic data, may help a more precise stratification of the risk of developing the disease.
The Hospital Marqués de Valdecilla has extensive experience in the early diagnosis of Alzheimer's disease by means of biomarkers of cerebrospinal fluid and functional imaging, and the Nuclear Medicine Service – in collaboration with the Cognitive Impairment Unit of the Neurology- A project to study the diagnostic value of the determination of cerebral amyloid by PET PiB sequentially. The results of this project are expected to be a significant advance in predicting individual risk of developing Alzheimer's disease.

Reference: Sánchez-Juan P, Seshadri S. Dynamic measurements of β-amyloid accumulation: The early effect of APOE. Neurology. 2017 Aug 9. pii: 10.1212/WNL.0000000000004344. doi: 10.1212/WNL.0000000000004344.