Carol Chan, MD, is a Geriatric Psychiatrist at the Lou Ruvo Center for Brain Health. She brought her expertise to this conversation on all things early detection—when to talk to your doctor, the process of being diagnosed, and what we can do when Alzheimer’s disease is caught early.
Read the interview with Dr. Chan below.
WAM: We know that memory changes are a normal part of aging. What are some symptoms women should look out for that could be signs that it’s time to talk to a doctor?
Dr. Chan: Memory changes such as occasional lapses of misplacing items or forgetting names are typical of normal aging. However, women should consult a doctor when memory changes occur frequently, interfere with daily activities, involve forgetting important information they previously would have remembered easily, or are noticed by family members.
WAM: What should you expect if your doctor suspects you are showing signs of dementia? What is the process for getting a diagnosis?
Dr. Chan: The process of getting a diagnosis starts with a thorough history from both you and a family member. The doctor will ask questions related to your memory concerns, review your medical history, medications, and risk factors. This is usually followed by a brief memory test and physical examination. Laboratory tests and brain imaging will usually be ordered to identify the cause and rule out reversible conditions.
WAM: Some of the biggest recent breakthroughs in Alzheimer’s and dementia research have been exciting new diagnostic tools. Do you recommend these tests to people who do not show signs of cognitive decline?
Dr. Chan: Blood-based biomarkers have been a very exciting breakthrough in the field of Alzheimer’s and dementia research and have the potential to improve access to early diagnosis. Current practice guidelines do not recommend blood-based biomarkers for people who are not showing signs of cognitive decline. These tests work best when someone is already having memory issues. When used in healthy people, they are not as reliable and can potentially lead to false positives. In someone who is not showing signs of cognitive decline, a positive test does not necessarily mean you will develop Alzheimer’s disease. Additionally, new Alzheimer’s medications are only approved for people who already have mild memory problems or early dementia. If you are not experiencing symptoms, there currently is no approved treatment, even if the test comes back positive.
WAM: What can actually be done differently when Alzheimer’s is caught early? Beyond emotional preparation and planning, what treatments or interventions today can meaningfully slow progression?
Dr. Chan: Early diagnosis of Alzheimer’s disease can give people opportunities to access medications that can slow down memory loss. Newer medications that target and remove amyloid plaques that build up in the brain from Alzheimer’s disease are only approved for people with mild memory problems or early Alzheimer’s dementia. The earlier you start, the better they seem to work. Early diagnosis also gives people time to implement lifestyle changes to improve their brain health. For example, regular exercise, maintaining a healthy diet, brain exercises, social activities and managing heart health.