Spotting Alzheimer’s Early: Proactive Care Prevent Up to 40% of Dementia Cases

A recent study from the Chinese University of Hong Kong reveals that nearly 22% of individuals aged 60 and older in the city have mild neurocognitive disorder or mild cognitive impairment, while around 10% meet the criteria for major NCD, or dementia. Early detection of these conditions is crucial in slowing progression and preserving function in patients, as the majority of dementia cases globally remain undiagnosed.

Timely screening, monitoring, and intervention at the primary-care level can significantly reduce treatment burdens and improve patient outcomes. Primary-care doctors typically administer memory tests, review medical history, conduct blood tests, and assess various daily functioning skills to diagnosing mild cognitive impairment or early-stage dementia.

In cases where cognitive abilities remain intact, physicians may label the condition as mild cognitive impairment. Conversely, when individuals struggle with daily tasks, further evaluation is required to determine if dementia has developed. Current diagnostic guidelines primarily rely on biomarkers, such as proteins like amyloid and tau, which are measured in the bloodstream.

A high level of p-tau217, p-tau181, and amyloid-beta 42 indicates an increased likelihood of Alzheimer’s disease. Blood tests are widely used in Hong Kong due to their smaller and more automated systems. However, the interpretation of results depends on the patient’s cognitive status. If the primary-care test demonstrates a high negative predictive value, it is highly unlikely that the patient has Alzheimer’s disease, and alternative causes for cognitive problems will be explored.

High sensitivity and specificity in blood tests enable doctors to accurately differentiate between those with and without the disease. In borderline cases, specialists may recommend additional diagnostic tools, such as an amyloid PET scan or spinal tap, to confirm a definitive diagnosis. Definitive diagnoses often necessitate more intricate procedures like amyloid PET scans, which are expensive and scarce in Hong Kong. However, these tests may be required for patients contemplating anti-amyloid antibody therapies.