Shana Dudley of Austin had a question for Dr. Dewayne Nash, the first speaker Tuesday at the Alzheimer’s Symposium in Temple.
With a family history of Alzheimer’s disease — her mother and maternal grandfather — Dudley, 44, wanted to know if she should start having the neuroimaging, blood work and genetic testing that Nash had done as part of a blind study and duplicated for his own use.
Nash said yes, because it would provide a baseline for any tests she might have in the future.
A family practice physician for a period at King’s Daughter’s Clinic, Nash was diagnosed with early amnestic mild impairment, a likely precursor to Alzheimer’s.
Nash’s diagnosis came as he was trying to join an Alzheimer’s study — Alzheimer’s Disease Neuroimaging Initiative — as a control subject at University of Texas Southwestern in Dallas. As a result of the initial exam, Nash became a patient.
His slight impairment made him a good candidate for alternate studies to identify the earliest changes in the brain through imaging, biomarkers — such as blood and cerebral spinal fluid — and cognitive testing.
‘I knew I had a problem’
Alzheimer’s is a degenerative neurological disease that slowly destroys memory and thinking skills and eventually the ability to do simple tasks.
“There’s no cure or treatment and it’s fatal,” Nash said. “It’s the sixth leading cause of death in the United States.”
Nash’s mother had Alzheimer’s, as did her father. His father probably had the disease but was never officially diagnosed. His younger brother, who is now in the late stages of the disease, was diagnosed in his 50s.
As soon as Nash received his diagnosis, he shut down his medical practice and began to spend more time with his wife and doing the things he enjoys in his organic garden.
Nash knows the day will come when he won’t be able to plan, plant or enjoy his garden.
“I think about that every day, but my wife and I want to enjoy the moment,” he said.
When Nash applied for long-term care insurance several years ago, he breezed through the cognitive assessment, which including repeating 10 words he had been told earlier in the evaluation. Three years later, when he was assessed for the UT Southwestern Study, he could only recall four words.
“That’s when I knew I had a problem,” he said.
Before seeing a neurologist, Nash had a number of medical tests to rule out other issues that might affect memory, including complete blood count, liver and kidney function, thyroid function, Vitamin B level, brain MRI and mental status.
Nash was prescribed Aricept, the first medication typically prescribed to a dementia patient.
“I’ve been on it for two and half years and my symptoms have been stable,” he said.
Lifestyle changes can help
The neuroimaging study is the largest of its kind and the data is used by researchers internationally.
Developing protein profiles could eventually be used in blood tests to determine the risk of someone’s developing Alzheimer’s, Nash said. A recent study had an 88 percent accuracy rate.
Scans can detect subtle changes in the volume of the hippocampus, which is responsible for short- and long-term memory. A spinal tap looks at the volume of beta amyloid and tau, proteins that may be useful in determining if a person is at risk for developing Alzheimer’s.
Beta amyloid becomes plaque and tau turns into tangles in an Alzheimer’s brain.
Things to do that could help stave off Alzheimer’s include controlling weight, blood pressure, cholesterol, diabetes, depression and anxiety. Also adopt a Mediterranean diet, exercise, get sleep, limit alcohol, don’t smoke, be happy and listen to classical music.
Dudley said her grandfather had and her mother has extremely high blood pressure and she, too, has a mild case of hypertension that is situational.
“That correlation between Alzheimer’s and hypertension makes me a little nervous,” she said.
As the mother of 10- and 12-year-old, Dudley is concerned for her children.
“I worry because my mother’s situation affects me, and I wonder what’s going to happen to me and its effect on my children. My mother has said hurtful things that have broken my heart several times, and I worry if I’ll do the same to my children.”