Alzheimer's disease is a brain
disorder that affects a person's ability to carry out daily activities. This
disorder is becoming an increasing problem in the United States as the
population ages. Alzheimer's disease affects approximately 5.1 million
Americans; 4.6 million of those affected are aged 75 years or older.1
Early diagnosis is believed to help patients maintain mental capacity; afford
patients the opportunity to make their own decisions while capable; inform
families of how to prepare for the future; and provide the best individualized
treatment. Analyses have shown that up to 50% of patients who meet the
criteria for dementia are not diagnosed in a primary care setting.1,2
The cause of
Alzheimer's disease is not fully understood; however, several anatomical,
chemical, and functional changes have been found to take place in patients
with the disorder. The main changes occur in the cortex and the limbic
structures of the brain, particularly the basal forebrain, amygdala,
hippocampus, and cerebral cortex.2 Numbered among the brain
alterations are cortical atrophy, degeneration of cholinergic neurons,
presence of neurofibrillary tangles, and accumulation of neuritic plaques.
2 These alterations also may be present in other conditions or even in
normal aging. The etiology of Alzheimer's disease is complex, and several
mechanisms must be taken into consideration. New developments are emerging
with respect to the roles of serotonin, glutamate, cholesterol, estrogen, and
genetics in Alzheimer's disease.
The existence of
memory disorders is difficult to assess initially. Signs are usually more
noticeable to the patient's family or close friends than to the patient. The
American Academy of Neurology does not recommend the evaluation or testing of
patients who are asymptomatic. Two organizations that have developed
guidelines for the diagnosis of Alzheimer's disease are the National Institute
of Neurological Disorders and Stroke and the Alzheimer's Disease and Related
Disorders Association.2 Guidelines also are included in the
Diagnostic and Statistical Manual of Mental Disorders. Given the high
number of underdiagnosed patients or patients diagnosed in the later stages of
the disease, there is a clinical need for a device or method that may aid
practitioners and patients with early diagnosis.
Early Alert Alzheimer's
Home Screening Test
Developed by FMG
Innovations, Early Alert is a noninvasive, self-administered olfactory test
designed to help the patient detect one of the early warning signs of
Alzheimer's disease. The manufacturer recommends that the screening test be
conducted annually if the patient is older than 50 years of age. The price of
the test ranges from $15 to $20, and it can be purchased only online or by
telephone. The Early Alert test consists of 12 different cards, each
containing a specific odor and a list of several choices from which the
patient must select. The test should be performed only once, and it should not
be conducted if the patient has congestion, sinusitis, or respiratory
problems, as such conditions may alter the results. If a patient cannot
distinguish four or more odors on the cards, the manufacturer recommends that
the patient seek medical advice from a physician. A more detailed procedure is
outlined in TABLE 1.
studies have been conducted that describe the changes to the olfactory nerve
and the nerve's relationship to Alzheimer's disease. No studies of the Early
Alert Alzheimer's Home Screening Test have been conducted; however, analyses
of a similar product were carried out at the University of Pennsylvania
Medical Center. In one study, Pentzek et al concluded that a decrease in
olfactory ability was more common in Alzheimer's disease than in depression
and that deterioration of odor differentiation may be a useful tool for early
diagnosis.3 In another analysis, Wilson et al demonstrated that
patients with lower global cognition at baseline had a faster decline in
olfactory capacity.4 More data are needed before it can be
definitively determined whether the deterioration in a patient's olfactory
ability is related to Alzheimer's disease.
The Early Alert
Alzheimer's Home Screening Test may be a better option for physicians than for
patients to use because the results can be misinterpreted by the layperson,
thus creating unnecessary anxiety in patients.5 More studies are
necessary before this product should be recommended to patients for home use.
More information about the Early Alert Alzheimer's Home Screening Test can be
found at the following Web site: www.testsymptomsathome.com/FMG01.asp.
Association. Alzheimer's Disease Facts and Figures 2007.
www.alz.org/national/documents/report_alzfactsfigures2007.pdf. Accessed May
2. DiPiro JT, Talbert
RL, Yee GC, et al. Pharmacotherapy: A Pathophysiologic Approach. 6th
ed. New York, NY: McGraw-Hill Medical; 2005:1154-1173.
3. Pentzek M,
Grass-Kapanke B, Ihl R. Odor identification in Alzheimer's disease and
depression. Aging Clin Exp Res. 2007;19:255-258.
4. Wilson RS, Schneider
JA, Arnold SE, et al. Olfactory identification and incidence of mild cognitive
impairment in older age. Arch Gen Psychiatry. 2007;64:802-808.
5. Test Medical
Symptoms @Home, Inc. Early Alert Alzheimers Home Screening Test.
www.testsymptomsathome.com/FMG01.asp. Accessed May 27, 2008.
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