The revelation that Pat Summitt, the 59-year-old women’s basketball coach at the University of Tennessee, not only has Alzheimer’s disease, but plans to continue her career, might seem astounding at first. But doctors expect such disclosures to become ever more common as experts get better at detecting the disease in its earliest stages.
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Indeed, in research out today in the journal Neurology, doctors from the Mayo Clinic report that by using certain brain scans they are growing ever closer to identifying people who will get Alzheimer’s before memory loss or any noticeable symptoms set in.
Such tests are still not there. Even when experts detect the onset of Alzheimer’s there are no medications that slow its inevitable progress. It's the search for such medications that motivates much of the research into early detection.
Scientists now believe that Alzheimer’s is a progressive condition with changes in the brain beginning decades before any symptoms appear and the only hope for an effective treatment may be to start treatment long before the onset of symptoms.
The Mayo Clinic researchers used brain scans on 311 people in their 70s and 80s with no symptoms of cognitive decline to determine the level of amyloid-beta deposits, or plaques, in their brains. The study found that 33 percent of the participants had significantly high levels of plaque deposits along with high molecule levels of myoinositol/creatine and choline/creatine in their brains. People with high levels of the brain molecules scored lower on several cognitive tests, regardless of the amount of plaque detected.
Scientists believe it might be necessary to treat patients with amyloid-lowering drugs long before significant symptoms of cognitive decline appear. However, it likely will take years to prove any of the drugs are effective.
But as Summitt plans to demonstrate, with the understanding of having the early stages and with assistance from others on her staff, it is still possible to continue a productive life until the disease worsens. Early onset Alzheimer's — when symptoms appear before age 65 — is uncommon, affecting only about 5 percent of all cases. It often runs in families and is linked to three genes.
Everyone with Alzheimer's progresses at a different rate and it's unclear what the Hall of Fame coach's future is going to be like. She has said she won't accept a "pity party" and realizes there will be "some good days and some bad days."
It will long be argued what effect the earliest stages of Alzheimer’s had on the careers of former President Ronald Reagan and former Prime Minister Thatcher of Britain. Both ended up with severe dementia after they left office, but both functioned successfully while they will still serving, at a time when they may have been in the early stages of the disease.
As earlier and earlier tests become available, some people may not want the information. But others do, so they and their families can plan for the challenges ahead — and in many cases, like coach Summitt — continue to function as long as possible.
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