Less than 25% of Alzheimer cases diagnosed in Canada

Three years ago, Jim Mann, a former airline employee who had travelled the world, froze in the middle of a small regional airport in the United States. He had no idea where he was, or what to do next.

Later, he got lost in his own neighbourhood. Then he drove his wife on a routine trip to the drugstore and blanked on how to get there, within yards of the destination.

After a few tests, Jim’s doctor told him he had dementia. After more rigorous testing, he was diagnosed with Alzheimer’s disease, the most common form of dementia. He was 58 years old.

Jim was lucky. He had been seeing the same doctor for years. When he described his symptoms, the doctor knew they were unusual for Jim. When he went for more extensive testing, however, one specialist questioned the diagnosis, saying, “You don’t look like you have Alzheimer’s disease.”

“I wasn’t sure how I was supposed to look,” Jim says. “Since then, I’ve been told I’m too young, too healthy, too capable, to have the disease. It can be a hidden illness for years, but when you have it, the impact is unquestionable.”

Elderly Canadians rate cognitive impairment and dementia as one of their top three concerns. According to figures released in January 2009 by the Alzheimer Society of Canada, one in 11 seniors has dementia. What’s more troubling, an estimated 70,000 Canadians under the age of 65, even in their 40’s and 50’s, are also affected.

Yet less than 25 per cent of Alzheimer cases in Canada are diagnosed and treated .

“Many Canadian doctors think that since you can’t cure, or slow the progression of dementia, a clinical diagnosis is less important,” says Dr. Jack Diamond, the Alzheimer Society’s Scientific Director. “But delay in diagnosis means that people don’t get the right care and are not identified for updates. New treatments, for example, are fast approaching the time when they’ll be available for doctors to prescribe.”

Diagnosing Alzheimer’s disease is, admittedly, not easy. Research has resulted in better diagnostic tools, but an accurate conclusion requires a number of methods over time.

Jim Mann suspects that people avoid seeking help because they are embarrassed or afraid. He recommends being persistent to get the answers needed. “A diagnosis lets you find help and gives you time to plan for the future,” he says. “There is no cure. But the medication today helps keep you functioning at a reasonable level. That’s a lot better than going undiagnosed for a long period of time and missing out on life.”

Become educated about dementia and know the warning signs. Visit www.alzheimer.ca.

Forewarned is forearmed

Why find out?

Symptoms of Alzheimer’s disease can be similar to other conditions such as depression, thyroid or heart disease, infections, drug interactions or alcohol abuse.

Finding out the cause of the symptoms can help people:

• Understand the source of the symptoms

• Get the proper care, treatment and support

• Plan for the future

What is involved?

No single test can identify Alzheimer’s disease. Diagnosing the disease is a complex and difficult process that takes the time and expertise of skilled practitioners. It can include:

•  Detailed history of the symptoms, including information from relatives or caregivers

•  Physical, neurological and mental status examinations

•  Psychiatric and psychological evaluations

•  Laboratory tests

•  Imaging of the brain

What about Memory Screenings?

Memory or cognitive screening tests are now available directly to consumers.

Generally based on a 3-5 minute mental status test, they can lead to inaccurate results with potentially serious consequences. For example, evidence shows that up to 40% can lead to a false negative or a false positive.

The Alzheimer Society does not support such screenings, whether self-administered or administered in public locations such as pharmacies.

If you are concerned, contact your doctor or the Alzheimer Society.

Your local Alzheimer Society – your life line

Your local Alzheimer Society offers practical care and support. For more information, visit www.alzheimer.ca .

¹ Howard H. Feldman MD, Claudia Jacova PhD, Alain Robillard MD, Angeles Garcia MD PhD, Tiffany Chow MD, Michael Borrie MB ChB, Hyman M. Schipper MD PhD, Mervin Blair BSc, Andrew Kertesz MD, Howard Chertkow MD. Diagnosis and treatment of dementia: 2. Diagnosis . CMAJ 2008/03/25;825-836.

Population Screening for Dementia – Position Statement – Alzheimer Society of Canada, August 2008 – www.alzheimer.ca/english/society/policies-popscreening.htm