With the US elderly population set to double over the next few decades, primary care physicians will play an important role in detecting and treating Alzheimer's disease. Charles A. Cefalu, MD, discusses how PCPs can detect the disease early, distinguish it from other forms of dementia, and treat it effectively.
Earlier this year, the National Institute on Aging and the Alzheimer’s Association laid out the first new guidelines for diagnosing Alzheimer’s disease in 27 years. Drawing on research finding that the underlying processes of the disease are set in motion years before any outward signs are evident and that the cognitive decline of those suffering from it proceeds gradually, the new guidelines distinguish between Alzheimer’s dementia and mild cognitive impairment from Alzheimer’s. In the latter, patients demonstrate reduced performance in one or more cognitive areas, but can still carry out their daily activities.
Primary care physicians (PCPs) are ideally situated to detect these early signs of Alzheimer’s in their patients, when medication and other therapies have the best chance of helping to slow the disease’s progression. However, studies have found that even when it has progressed to full-blown dementia, Alzheimer’s is widely underdiagnosed in the primary care setting. The challenge of diagnosing and treating Alzheimer’s will only grow as the elderly population in the US doubles over the next four decades. By 2050, the number of Americans over 65 with Alzheimer’s dementia is projected to reach between 11 and 16 million, up from 5.2 million today.1
To get some insight on how PCPs can improve their detection of Alzheimer’s, MD Magazine: Peers & Perspectives spoke with Charles A. Cefalu, MD, professor and chief of geriatrics at the LSU Health Sciences Center School of Medicine at New Orleans, who coauthored a 2010 international position paper on the PCP and Alzheimer’s.2 To read an edited transcript of our interview with Cefalu, click here.
1. 2011 Alzheimer’s Disease Facts and Figures. The Alzheimer’s Association.
2. Villars H, Oustric S, Andrieu S, et al. The primary care physician and Alzheimer’s disease: an international position paper. J Nutr Health Aging. 2010;14(2):110-120.