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Highly educated people 'could miss out on Alzheimer's treatment'
Highly educated people could miss out on Alzheimer's treatment while others
are wrongly given drugs because the diagnosis test is not sufficiently
accurate, a Cambridge neuropsychology professor has warned.
By Rebecca Smith, Medical Editor
11 Oct 2010
Prof Barbara Sahakian warned that intelligent people could pass the test
despite being in the early stages of the disease.
The NHS drugs rationing body has proposed changing its guidance to allow
three drugs previously limited to those in the moderate and severe stages of
Alzheimer's to be given to those in the mild or early stages.
While welcoming the reform, Prof Sahakian warned that the test currently
used to detect early Alzheimer's is so poor the new guidance may make little
practical difference.
The "mini mental state examination" is used to screen for early Alzheimer's
but includes questions such as who is Prime Minister, what is the date today
and remember three things you did yesterday.
As well as missing high functioning people with early Alzheimer's disease,
the test is language based so people who cannot speak good English are at a
disadvantage and may fail the test even though they are healthy, she added.
"The MMSE is not fit for purpose in detecting early dementia. It is far too
easy and not sensitive enough.
"The trouble is that it is not going to detect mild people, especially
bright people, so what is the point in changing the drugs guidance?"
She said other tests are available which examine a person's ability to
remember newly acquired learning as this is the first sign of deterioration.
One test produces six patterns in boxes on a screen and patients then have
to remember where they were once they are hidden again.
Healthy elderly people tend to do very well on the test while those who are
in the early stages of the disease are detected easily and cheaply.
Prof Sahakian said: "It is so frustrating. After all those people had to
suffer because the drugs were withheld and now they have finally reversed
that decision they are going to continue with a poor test that will not
detect those early cases who can now benefit from treatment."
© Copyright of Telegraph Media Group Limited 2010
From: A. Papazian
Highly educated people could miss out on Alzheimer's treatment while others
are wrongly given drugs because the diagnosis test is not sufficiently
accurate, a Cambridge neuropsychology professor has warned.
By Rebecca Smith, Medical Editor
11 Oct 2010
Prof Barbara Sahakian warned that intelligent people could pass the test
despite being in the early stages of the disease.
The NHS drugs rationing body has proposed changing its guidance to allow
three drugs previously limited to those in the moderate and severe stages of
Alzheimer's to be given to those in the mild or early stages.
While welcoming the reform, Prof Sahakian warned that the test currently
used to detect early Alzheimer's is so poor the new guidance may make little
practical difference.
The "mini mental state examination" is used to screen for early Alzheimer's
but includes questions such as who is Prime Minister, what is the date today
and remember three things you did yesterday.
As well as missing high functioning people with early Alzheimer's disease,
the test is language based so people who cannot speak good English are at a
disadvantage and may fail the test even though they are healthy, she added.
"The MMSE is not fit for purpose in detecting early dementia. It is far too
easy and not sensitive enough.
"The trouble is that it is not going to detect mild people, especially
bright people, so what is the point in changing the drugs guidance?"
She said other tests are available which examine a person's ability to
remember newly acquired learning as this is the first sign of deterioration.
One test produces six patterns in boxes on a screen and patients then have
to remember where they were once they are hidden again.
Healthy elderly people tend to do very well on the test while those who are
in the early stages of the disease are detected easily and cheaply.
Prof Sahakian said: "It is so frustrating. After all those people had to
suffer because the drugs were withheld and now they have finally reversed
that decision they are going to continue with a poor test that will not
detect those early cases who can now benefit from treatment."
© Copyright of Telegraph Media Group Limited 2010
From: A. Papazian