Alzheimer’s disease has joined cancer at the top of the list of feared diagnoses, and although Alzheimer’s does have the potential to devastate millions of patients and families, there are reasons for hope – and possibly opportunities to reduce risk or alter the course of disease progression, according to Keith Black, MD, professor and chair of the Department of Neurosurgery at Cedars-Sinai.

“With no cure, no effective treatment and not even a reliable, practical way to diagnose it, Alzheimer’s has become one of the most dreaded diseases of our time,” said Black, director of Cedars-Sinai’s Maxine Dunitz Neurosurgical Institute, director of the Johnnie L. Cochran, Jr. Brain Tumor Center and the Ruth and Lawrence Harvey Chair in Neuroscience.

“When we talk about new noninvasive technology aimed at providing early detection, many people say they wouldn’t want to know in advance. The outlook is just too frightening and they say there’s nothing they could do about it anyway. But there’s a lot of misinformation about the disease, and emerging data suggest that some very simple things we can do right now might change its course, especially if we intervene early in disease progression – years before symptoms begin,” Black said.

Until recently, the hallmark changes in the brain leading to a diagnosis of Alzheimer’s disease could be seen only after death in brain sections treated to reveal plaques containing beta-amyloid protein and neurofibrillary tangles containing abnormal tau protein. Special imaging studies – positron emission tomography, or PET scans – and tests of cerebrospinal fluid now offer the best – though imperfect – chance to detect and diagnose the disease in living patients. But spinal taps cause discomfort and PET scans require injection of a radioactive tracer. Even if the tests were 100 percent accurate, however, they would not be convenient, practical or cost-effective as an early screening method, Black said.

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