Washington DCIn my last post I wrote about the possibilities for error that lie in the fuzzy borders around each of the current diagnostic criteria for Alzheimer’s. I’d like to tie together some loose ends from that post.
New Diagnostic Criteria Involving PET Scans and Other “Biomarkers”
The diagnostic criteria for Alzheimer’s are becoming more precise and reliable as new laboratory and x-ray tests for physical evidence (called “biomarkers”) become available. The current definitions (that I examined in the last post) use only the outward symptoms of the disease. Once biomarkers are added to the diagnostic criteria, the diagnosis becomes more reliable. The PET brain scans now being evaluated, for instance, can see the amyloid protein deposits in the brain that are directly associated with Alzheimer’s. Analysis of cerebrospinal fluid can detect the tau protein that is similarly associated with Alzheimer’s. Much research is still being conducted to determine exactly how to incorporate these biomarkers into the diagnosis.
Some things are already very useful. If the PET scan for amyloid is negative, for instance, you almost certainly don’t have Alzheimer’s. (If there is amyloid, it’s not so clear since about 20% of those people apparently do not have Alzheimer’s.) But the several biomarkers that will soon be available in clinical practice will make the diagnosis of Alzheimer’s much more reliable.
The Trouble with Anecdotes
My experience of the past sixteen months is a good example of the problems with anecdotal evidence, that is, individual stories that cannot be statistically evaluated. Over the past year, friends and readers have recommended dozens of different treatments (sometimes even suggesting that doctors or drug companies are hiding them from us). These sincere recommendations have usually been based on stories of individual patients who took the treatments and got better. I responded to the comments (here and here) that I probably wouldn’t even look into the suggested treatment because, basically, I trusted medical science to look into any reasonable possibility for cure. If medical science wasn’t looking into it, I wasn’t going to bother, either. I keep myself healthy with diet and exercise, but I haven’t taken any special treatments.
What might have happened if I had taken, say, coconut oil, as a treatment? How many would interpret my “cure” as “proof” that coconut oil worked. In reality, it would have been just a coincidence. The purpose of rigorous scientific testing is to make sure that coincidences, improvements based on the placebo effect, original misdiagnoses (as in my case) or other issues are not involved.
Isn’t it possible, some of my friends ask, that a new untested treatment works and will later be scientifically justified. Of course. I criticize no one who wants to try one of the many suggested treatments. But I wasn’t personally willing to spend my emotional energy going back and forth trying one or another on the basis of the latest anecdotes. I know some readers will jump on me for this, but, before you comment, please at least go back and read the two posts (here and here) that I wrote on the subject.
It’s a Miracle Anyway
In spite of all I’ve written above, I still experience this “cure” as a miracle. It’s not that the natural laws of the universe have been overruled or suspended or that something scientifically impossible has actually happened. Finding myself free of Alzheimer’s is a miracle because it’s something completely unexpected, something that I would have considered impossible a year ago, something that gives me hope, something that returns my life when it seemed to be disappearing. Sure, I can go back and explain each step scientifically, as I have over the last several posts. What has happened broke no laws of science … but it’s nevertheless a miracle.
A New Title for My Blog
Given that I don’t have Alzheimer’s and that my cognitive impairment is not progressing, the title of this blog, “Watching the Lights Go Out,” seems to me a bit inappropriate, so I’m inviting suggestions for a new title (or, perhaps, reasons to keep this title). My son-in-law suggests “Stop Playing with the Dimmer.” What are your suggestions?