The Alzheimer's Association Facts and Figures Report for 2020 Is Now Out

I'm hoping that all of our readers are well, both physically and emotionally.  These are difficult times, but we will persevere.  

Each March I wait for publication of the Alzheimer's Association annual Facts and Figures Report.  (I wrote about last year's report here.)  This is my first go-to resource, and I cite it often in both editions of Beating the Dementia Monster.  So they have now published the 2020 edition, and I have downloaded it.  The report updates the statistics on the disease each year, but it also explains and updates what research is telling us about the disease.  This year adds another increment to our understanding.

We covered most of what's new and (to me, at least) interesting in our regular blog posts since last March.  As the news comes out, I try to write about it promptly.

One thing that struck me was their inclusion of a graphic in this year's report showing the progress of Alzheimer's disease from the pre-clinical stage through the third stage of Alzheimer's dementia.  I made a similar graphic here, and I use it in presentations and in the (still forthcoming) second edition of Beating the Dementia Monster.  In my presentations and in the book's discussion I break down Alzheimer's disease into its five stages (pre-clinical AD, MCI, mild dementia, moderate dementia, and severe dementia), but in my graphic I only show Alzheimer's dementia as a single, final stage of the disease -- so three stages.  Their graphic breaks dementia down into its three stages, so their graphic shows five total stages of the disease (pre-clinical, MCI, and the three individual stages of dementia).  Theirs may be more helpful.

Something that caught my attention was a discussion of the importance of an accurate diagnosis of the cause of a dementia case.  Alzheimer's disease is responsible for 60 to 80 percent of dementia cases, but there are other causes, and their treatments will vary.  This contradicts the too-common practice of diagnosing Alzheimer's disease purely on the basis of a single Mini-Mental Status Exam or a Montreal Cognitive Assessment.  At Harborview in Seattle, they subjected me to a couple of hours of psychometric testing and a brain MRI.  I've also had blood tests looking for vitamin deficiencies and other potential causes of my MCI.  These are required for an accurate diagnosis and an appropriate course of treatment.

Something else they highlighted was a research finding that people who are concerned enough about deteriorating cognition to consult a heath professional often do have Alzheimer's disease or another cause of dementia.  Everyone over about 60 begins to worry if they have Alzheimer's disease, but if they're not worried enough to see a medical professional about it, it's likely they are simply experiencing the result of normal aging.

They continue to promote annual screening for neurodegenerative disease, emphasizing that it's part of Medicare for everyone over 65.  But doctors say they're too busy to do it, and a lot of their patients tell them they don't want to know if they have Alzheimer's disease.  So we continue to not test enough.  On the other hand, they (like us) noted that we are close to a very sensitive blood test for Alzheimer's disease, and I'd bet these tests will become routine soon enough for everyone over 65.

They have re-worded the discussion of the role of lifestyle changes in addressing Alzheimer's disease, but I didn't see anything new.  The role of lifestyle changes is, of course, the thesis of Beating the Dementia Monster.

They simplified their discussion of brain changes over what they had last year, notably the roles of beta amyloid and tau tangles.  I think it's helpful to read both of them -- this year's and last year's.  The two articles overlap a lot, but each seems to have insight missing from the other.

They didn't focus quite so much this year on what to expect in the future, but their discussion is no less bleak than last year's.

If you're nerdy, you'll want to read the first three chapters, but we covered most of the material here our blog over the past 12 months.  If your focus is on caregiving and the consequences of dementia, you'll want to read chapters four through six.