Alzheimer's is
increasing at a rapid rate in California — at least 66,000
Orange County residents have the disease. Yet most individuals
do not receive a diagnosis until they are well into the
moderate stages of the disease.
That's a concern for Dr. Malcolm B. Dick,
neuropsychologist at UC Irvine's MIND Institute (the Institute
for Memory Impairments and Neurological Disorders).
"With the right diagnosis, we might be
able to make a difference and lower the risk of the disease
progressing to a different stage," he says.
Q. You have diagnosed more than 6,000 people
in your 20-plus years with the Institute. In fact, you have
just been awarded the Institute's first MIND Award. What has
changed about diagnosing the disease over the years?
A. Boomers are so sensitized to cognitive
illness that they worry if they notice a change. That is the
good news. When the clinic opened in the 1990s, the majority
of patients we saw were already into mild or moderate
dementia.
Now, we see a lot of people in the first
five years of mild cognitive impairment. They may not have
dementia but a memory loss from some other problem that they
are concerned about. It's a good thing they are coming in. It
might make a difference and lower the risk of the problem
progressing to a different stage.
Now, something can be done to lessen the
likelihood of dementia.
Q. What percentage of the people you see
have Alzheimer's? A. Probably 65 percent of the people I
diagnose have Alzheimer's. Other causes of dementia can
include a stroke, hypothyrodism or not enough B12. And then
there are 10 to 15 percent who will have Lewy Body, a form of
dementia which, like Alzheimer's, is not reversible.
Q. I am told you have an accuracy rate of 90
to 95 percent in your diagnosis. The average rate for a
diagnosis by a physician is 80 percent. What is your
procedure?
A. We do a comprehensive evaluation for
dementia and that includes a complete medical history, changes
in behavior, initial symptoms. There is a physical examination
and a neurological examination. This helps us to identify such
problems as inappropriate use of drugs or a combination of
drugs. The history tells us if this is a slow, insidious
projection — more characteristic of Alzheimer's.
We look for sensory or motor changes. How a
person walks, the gait and the arm swing. It takes a little
bit of time.
Q. And the cost?
A. About $450.
Q. Huge numbers of people are projected to
have dementia in the future because so many of us are living
longer. This is a disease that comes with aging, but I am told
more women than men over age 90 exhibit dementia. Any
thoughts?
A. We're studying why a gender difference
increases the risk of dementia with age, but I have no answer
for you yet.
Q. Any way to prevent dementia?
A. We believe lifestyle — physical and
mental exercise, lower blood pressure and cholesterol, diet
— makes a difference in how the disease progresses.
Q. And if I want to make an appointment to
see you at the UCI MIND Institute?
A. Call the Institute at (949) 824-2382
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10 Warning Signs of Alzheimer's
1. Memory changes that disrupt daily life 2.
Challenges in planning or solving problems 3. Difficulty
completing familiar tasks 4. Confusion with time or place 5.
Trouble understanding visual images and spatial relationships
6. New problems with words in speaking and writing 7.
Misplacing things and losing the ability to retrace steps 8.
Decreased or poor judgment 9. Withdrawal from work or social
activities 10. Changes in mood and personality
—UCI MIND Institute