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Brain scan can help screen for dementia

By Glenn Haas
January 13, 2009

What if you could look inside your head and see how old your brain really is? What would you learn?

Physicians can already see tau tangles and amyloid plaques, both critically important in early detection of brain aging. Tangles are the first abnormal proteins that appear in the brain, long before dementia is clinically obvious, says Dr. Jorge R. Barrio, a professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA.

These subtleties allow more insight into how the plaques and tangles spread and ultimately how Alzheimer's might develop, he says.

But now Dr. Gary Small at UCLA is using a brain-scan technology, along with patient information on Alzheimer's disease risk, to help diagnose brain aging before these symptoms appear.

He holds the UCLA Parlow-Solomon chair on aging and is a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA.

The study, published in the current issue of "Archives of General Psychiatry, says this might be a more accurate method for tracking brain aging.

Dr. Small — author of several books, including "The Longevity Bible" — talked with me about the potential of the new technology.

Q. Does this mean physicians will be able to predict who will get Alzheimer's?

A. I don't think we're quite at that stage, but this is tremendously promising and shows we are going down the right road. We are trying to combine and refine our tools.

Q. The study says you are using positron emission tomography (PET), which allows a "window into the brain" of living people and shows signs of neurodegeneration. Put that in layman language.

A. With key patient information we can better predict those who may benefit from early Alzheimer's interventions, as well as help test how well treatments are working.

Q. You had 76 volunteers, including 34 who carried the APOE-4 gene allete, which heightens the risk for developing Alzheimer's. You found brain changes?

A. We found subtle changes, which take place before symptoms manifest. We could see more advancing disease in those volunteers with mild cognitive impairment, who are already demonstrating some minimal symptoms. Eventually, this imaging method, together with patient information like age, cognitive status and genetics, may help us better manage brain aging.

Q. So can the average person get this test? Or should they?

A. Here's the challenge. Medicare won't always pay for this. Still, a lot of people want the information even if we don't have a magic bullet — a cure. It can dictate prevention treatment. And if we ever get that bullet, obviously this test is even more important.

Q. When do you think a treatment will be available?

A. I'm optimistic. I'm thinking five to 10 years.

Q. Meanwhile, what can people do to keep brain health? Crossword puzzles?

A. I've written three books on this topic. And I've done a lot of research. What we know is what's good for the heart is also good for the brain. That means eat a Mediterranean diet, reduce or manage stress, get regular physical exercise. Whether or not mental exercise helps, we don't know yet. We do know it improves performance.

Doing any exercise is not going to hurt. Just searching on Google exercises the brain. I tell patients to do what they enjoy doing because they will be more likely to do it.

Stay active.

Q. And someday?

A. Someday there will be a brain check like a cholesterol check. You do a blood test, find your cholesterol is high and take statins to reduce it. Someday, you have a brain scan, we can say take this drug and you will lower your risk for developing Alzheimer's. Someday.

Original source: http://www.ocregister.com

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