Earlier detection and with it the possibility of earlier, more effective treatment for Alzheimer’s Disease.

No real breakthrough has been reached yet but, as The New York Times reports, science is ready to rewrite the books on Alzheimer’s disease in a way that may usher in earlier detection and with it the possibility of earlier, more effective treatment.

The National Institute on Aging and the Alzheimer’s Association have come together to issue a new definition and medical guidelines for Alzheimer’s, the first serious reworking of the definition in 27 years. The full onset of dementia, what we classically define as the hallmark of the disease, is now thought of as the final of three progressive stages. Research indicates that the disease affects the brain long before the onset of dementia, and the first stage often shows no outward symptoms at all even as the brain begins to change. The second stage is an intermediary phase where neurological symptoms begin to set in but with little indication of the full extent to come.

The most striking addition to the guidelines concerns methods that assess brain changes, including brain scans and tests of cerebral spinal fluid. These methods measure biomarkers, the physiological indicators that someone is likely to develop dementia eventually, just as cholesterol and blood pressure are biomarkers of impending heart disease.

Will this affect medical practice just yet? Not quite. For now, the guidelines specify that Alzheimer’s biomarkers should not yet be put into widespread use, but used only with patients enrolled in clinical trials. That is because scientists cannot yet standardize the test results.

The importance, according to Dr. Pierre Tariot, director of the Banner Alzheimer’s Institute in Phoenix, is that we understand the disease to be a very long process. “The notion that Alzheimer’s disease is a continuum that has an extensive pre-symptomatic phase is a very important message to get out.”

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