How can I tell the difference between depression and AD?
A semi-structure questionnaire such as the one developed by CERAD – (the Consortium to Establish a Registry for Alzheimer’s Disease) works well to find out if cognitive complaints are caused by depression. The problem is that depression and dementia (especially in mild stages) often co-exist. When there’s a doubt, an anti-depressant is usually tried for a few months, then dementia-specific drugs are added.
There are dominantly-inherited genes causing AD, usually before age 65. There is one common gene (ApoE) that increases the risk between ages 65 to 75. There are multiple weak genes increasing the risk over 75.
There is currently no cure for AD but there are a lot of symptomatic treatments, both pharmacologic and non-pharmacologic, that help patients and families. There is building evidence that the risks associated with ApoE and weaker genes are compensated for by education and life-style changes (look up the FINGER study in Finland).
Old drugs like Naproxen and Probuchol may reduce progression in persons at high risk , studies are being done at Douglas’ Stop-AD Center. Young patients carrying one of the dominantly-inherited genes for AD will be offered anti-amyloid therapy, done at the McGill Center for studies in Aging. A Canada-wide study on the natural history of AD and related disorders is starting (CCNA Study, led by Dr Howard Chertkow).