New York Times (August 4, 2017): Caregiving Is Hard Enough. Isolation Can Make It Unbearable

Alzheimer’s disease now affects an estimated 5.5 million Americans, and after decades of feverish work, researchers have so far failed to find a treatment that halts or reverses the inexorable loss of memory, function and thinking ability that characterize this feared illness.

But researchers have been quite successful at devising ways to diagnose Alzheimer’s earlier and earlier. And that capability has emerged alongside evidence of a tantalizing possibility: that if you can catch the disease early enough — ideally when symptoms of confusion or memory loss are just emerging, or before — some therapies already in hand might essentially halt its progress.

For anyone who detects some mental slippage and wonders, “Is it Alzheimer’s?” the current state of dementia research raises a very real, and very wrenching, dilemma: If I can know, do I want to know?

That is, if it’s Alzheimer’s disease, would I do anything differently? Would there be some benefit in knowing for my loved ones, for myself?

Doctors and insurers, including the federal government, which administers Medicare, are asking some variants of the same questions: If an effective test, which costs between $3,000 and $5,000 a shot, can diagnose dementia early, and distinguish Alzheimer’s from other forms of dementia, should it be recommended to patients with cognitive concerns and routinely covered by their insurance? Would it make patients’ lives better, or lower the cost of their care?

Newly unveiled research results are bringing some clarity to such deliberations. And other new research, published Wednesday in the journal Neurology, proposes a new diagnostic tool that may be able to detect Alzheimer’s, and distinguish it from another form of dementia, more simply and cheaply than does the best test now available.

At the Alzheimer’s Assn. International Conference in London last week, researchers reported their preliminary findings from a trial that is testing the impact of diagnostic testing for Alzheimer’s disease on nearly 19,000 Medicare beneficiaries.…

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