This week, Bobbi Conner talks with Dr. Nicholas Milano about the importance of early diagnosis and treatment of Alzheimer’s disease. Dr. Milano is a neurologist specializing in cognitive disorders and dementia and he’s Director of the South Carolina Alzheimer’s Network (SCAN) at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. In South Carolina, it's estimated that 11.5% of individuals over 65 years of age are living with Alzheimer's disease and related dementias. Doctor Nicholas Milano is here to talk about the importance of early diagnosis and treatment for Alzheimer's. Doctor Milano is a neurologist specializing in cognitive disorders and dementia, and he's Director of the South Carolina Alzheimer's Network at MUSC. Doctor Milano, why is early diagnosis of Alzheimer's important?
Dr. Milano: Well, for one, not everything is Alzheimer's disease. So, one of the goals in our clinic is to determine if another cause is causing the symptoms. And beyond that, if it is Alzheimer's disease, we want to make sure we get you on medications, which the evidence has shown are more effective the earlier you start them.
Conner: Besides Alzheimer's, what are some of the other common conditions or maybe even medications that could be causing memory issues or cognitive decline?
Dr. Milano: Well, one of the biggest things is vascular disease. People with a history of high blood pressure, high cholesterol, diabetes often will have vascular disease in their brain, which can also cause cognitive symptoms. But then also there's reversible things like sleep apnea, alcohol, and also some medications, like over-the-counter sleep meds, which can also cause cognitive symptoms.
Conner: How is Alzheimer's accurately diagnosed?
Dr. Milano: It requires a thorough history, along with a neurologic exam and some objective cognitive testing. Then we typically get a scan of the brain, like an MRI scan and potentially some additional Alzheimer's specific tests. There's been a lot of info in the press about the blood tests for Alzheimer's or special scans for Alzheimer's. And while those are useful, they don't tell the whole story. We also have to do a thorough neurologic history and examination to make sure that everything is fitting together and actually looks like it's caused by Alzheimer's disease.
Conner: Tell us about the South Carolina Alzheimer's Network and how it connects neurologists with primary care physicians throughout South Carolina to assist with early diagnosis of Alzheimer's.
Dr. Milano: Well, one issue that is true throughout the entire United States, but in particular South Carolina, is that we are never going to have enough specialists or neurologists that take care of patients with Alzheimer's disease. So, the South Carolina Alzheimer's Network, or SCAN, is designed to give that added expertise to primary care providers to help them better start the evaluation and diagnosis of Alzheimer's disease and related disorders.
Conner: And how does this plan really work between the neurologists and the primary care physicians?
Dr. Milano: So, we've developed an eConsult model, which is basically where the primary care provider starts the initial evaluation, then sends us the patient's chart. We're able to review that in depth, as well as look at any imaging or other studies. And then we're able to communicate remotely with the primary care provider to give guidance or to bring the patient in to see us in person.
Conner: What treatments are available in the early stages of Alzheimer's?
Dr. Milano: Well, this is where there's been some exciting developments in our field over the last 2 to 3 years. Two medications have come onto the market, one lecanemab, the other donanemab, which actually have been shown to slow down the progression of Alzheimer's disease. But it's not for everyone. And it's important to be evaluated by an expert in these disorders, to determine if these medications are right for you.
Conner: Doctor Milano, thanks for talking with us about early diagnosis of Alzheimer's.
Dr. Milano: Thank you very much.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
