So how many clinical studies am I participating in? I'm losing track. We're here in Seattle right now for a session that I participated in yesterday at the University of Washington, a study to evaluate methods of diagnosing Alzheimer's disease by examination of the retina of the eye. This is to be repeated annually and indefinitely. But I've also been taking cognitive tests at home every week for some time now so that someone can track my decline over an extended period of time. (I am still declining, it's just that since altering my lifestyle in 2016 my decline seems to be much more in line with normal aging.) In Beating the Dementia Monster, we wrote about our participation in the Mayo Clinic's HABIT study, and I've participated in a couple of other one-time studies of one type or another. From time to time I'm reminded of something I'd signed up for a long time ago but forgot about.
Yesterday's test was very interesting. Diagnosing Alzheimer's disease remains as much an art as a science, and multiple forms of evidence are required by the diagnosis protocol. Reports are taken from family members regarding behavior, and then cogitative tests are given. But the diagnosis still requires biomarker evidence, something tangible. In my case, it was an MRI that showed significant atrophy of my brain.
But, as things stand today, the final diagnosis is only made in the autopsy.
More reliable methods for evaluating biomarkers are advancing. We've discussed blood tests before, and these are very promising. We've also discussed the possibility that evidence of Alzheimer's disease may be found by examination of the retina of the eye. Yesterday's tests were all about my retina.
The whole process took about three hours. They told me that I was subject #55, and they were hoping to eventually have 150. After a battery of cognitive tests, they gave me an eye exam, saying that I had 20/20 uncorrected in both eyes. (This will be news to my optometrist who says I have 20/30 in one eye and 20/40 in the other.) Then they dilated my eyes and led me through a series of retinal exams using three different machines. Each of the machines took different kinds of images of my retina.
I chatted with the researchers regarding what they were looking for. I told them I knew that UW was a pioneer in finding amyloid plaques in the retina of the eye that might be a biomarker for Alzheimer's disease. (They said other people were working on that one, not them.) An ophthalmologist once told me that an amazing portion of all the information coming to the brain is just via the optic nerve ... eyesight. I don't remember the number he gave me, but it was a high percentage. And so some consider the eye to simply be an extension of the brain. Bad things happening in the brain proper may also be occurring in the retina.
I should have taken notes, but I didn't, and now I can't remember everything they told me. But I recall the last machine imaged my eye for oxidative stress. If you read Beating the Dementia Monster, you know that part of how Alzheimer's disease proceeds in the brain is via oxidation inside neurons that kills them. One hypothesis they are testing is oxidation proceeding in the brain should be reflected in oxidative damage in the retina.
The cognitive tests they gave me were disturbing. I take cognitive tests every Thursday, and I feel that I do reasonably well on them. But the tests they gave me yesterday were hard, and I'm not sure I got anything right on them. They couldn't tell me the results, but they were going to share them with my neurologist and/or my neuropsychologist. I'll be interested in their take.
For our trouble, they gave us a $10 Amazon gift card (a typical token of appreciation for these trials) and $40 for our gas. They said they hoped we'd be back again next year for a follow-up. My intention is to return, since I'm always interested in supporting Alzheimer's research.
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