Autopsy guidelines revised for Alzheimer's

July 18, 2011
Advertisement

For many years, an autopsy done by a pathologist was considered the best way to confirm the presence of Alzheimer’s disease.

But new guidelines proposed on Sunday by the U.S. National Institute on Aging and the Alzheimer’s Association seek to distinguish between memory changes or dementia diagnosed by doctors when people are alive, and the changes pathologists can see in an autopsy.

The proposed guidelines will offer additional information about the disease that will help as scientists develop tests that measure biological changes in the brain, blood or spinal fluid to diagnose Alzheimer’s at an earlier stage.

Advertisement

Several companies, including Eli Lilly and Co, Bayer and General Electric Co, are working on compounds to identify Alzheimer’s-related brain changes on positron emission tomography scans.

Many other companies and researchers are working on other types of biomarkers as well.

“Someday biomarkers are probably going to replace pathology,” Dr. Creighton Phelps of the National Institute on Aging’s division of neuroscience, said in an interview at the Alzheimer’s Association International Conference in Paris.

Pathologists now look in the brain for clumps of a protein called beta amyloid and a protein called tau to diagnose Alzheimer’s disease.

But studies have shown that people can die with lots of plaques and tangles in their brain and still have normal cognitive function.

“We know people die with Alzheimer’s changes in the brain but they had no dementia,” Phelps said.

According to the proposed guidelines, patients who have memory problems caused by the disease will be diagnosed with Alzheimer’s dementia, or in milder cases, mild cognitive impairment (MCI) due to Alzheimer’s dementia.

The term Alzheimer’s disease will be used to refer to the underlying changes in the pathology, Phelps said.

“Classically, it’s all been one big pool but they are not equivalent,” he said. “You might have something on a slide that doesn’t match what the person was like in life.”

Phelps said dementia can be caused by many diseases, including vascular disease, so it is important to be clear about what is causing the problem.

The proposed guidelines offer much more detail about how to test people’s brains at autopsy, specifying tests that should be done and asking pathologists to quantify the amount of plaque in the brain.

Bill Thies of the Alzheimer’s Association said knowing the location of the plaques in a person’s brain may provide clues about why some people develop dementia and others do not.

If these protein deposits are clustered in memory centers of the brain, that could cause more problems than if they are in other parts, for example.

Earlier this year, the NIA, part of the National Institutes of Health, and the Alzheimer’s Association issued new diagnostic criteria to help doctors better classify patients who are tested for signs of dementia.

The proposed pathology guidelines, which are part of that process, will be available for public comment until September 1. Phelps said he hopes final guidelines will published in January 2012.

Source

CDFuneralNews

CDFuneralNews

ConnectingDirectors.com is the leading online daily publication for funeral professionals with a reader base of over 45,000 of the most elite and forward-thinking professionals in the profession. With ConnectingDirectors.com we have created a global community through an online platform allowing funeral professionals to Stay Current. Stay Informed and Stay Elite.
CDFuneralNews
Advertisement

You may be interested

Download Our FREE Memorial Day Video
Funeral Industry News
199 views
Funeral Industry News
199 views

Download Our FREE Memorial Day Video

CDFuneralNews - May 24, 2018

Finding the right Memorial Day content to express your gratitude and honoring those who have fallen for our country can…

FrontRunner Unveils its New ‘Final Resting Place’, GPS Enabled App
Frontrunner Professional
177 views
Frontrunner Professional
177 views

FrontRunner Unveils its New ‘Final Resting Place’, GPS Enabled App

CDFuneralNews - May 24, 2018

FrontRunner today announced the unveiling of the new GPS enabled App, Final Resting Place, which allows funeral homes, cemeteries and…

Learn How Your Funeral Home Can Offer Natural Burials in The Green Burial Guidebook
Funeral Industry News
156 views
Funeral Industry News
156 views

Learn How Your Funeral Home Can Offer Natural Burials in The Green Burial Guidebook

Justin Crowe - May 23, 2018

The Green Burial Guidebook is a new book by Elizabeth Fournier explaining the methods and ideas behind having an affordable, environmentally…

Comments