February 19th, 2011 at 3:06 am
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Micro-bleeds in the brain may be linked to Alzheimer’s disease, according to study

by Carol Bursack

Lately, I’ve been reading about doctors finding “mixed dementias,” as they attempt the tricky diagnosis of people with dementia symptoms. This makes sense to me. Several people have told me about an aging parent who has been diagnosed with Alzheimer’s, only to find out later that the diagnosis should have been vascular dementia with some additional symptoms that could point to possible Alzheimer’s disease.

After reading an article on msnbc.com titled “Brain micro-bleeds provide clue for Alzheimer’s origins: Blood vessel damage linked with plaque buildup may cause disease, studies suggest,” I couldn’t help wonder if these micro-bleeds are part of the mixed dementia equation.

Let me be very clear that I’m not a medical person, and I’m not trying to interpret anything medical. Rather, I’m just a curious lay person with a strong interest in dementia.

The msnbc.msn article states that, “Brain micro-bleeds, stemming from tiny, ruptured blood vessels, might help explain how blood vessel damage and amyloid plaque buildup work together to cause Alzheimer’s disease”

Alzheimer’s disease is typically recognized by amyloid plaque buildup in the brain. The disease is often diagnosed by employing a battery of tests, including a PET scan. PET scan images help doctors find abnormalities of brain function, therefore they have greatly increased the accurate diagnosis of Alzheimer’s disease. The presence of micro-bleeds may help a doctor determine the type of dementia present.

Unfortunately, not all people with dementia symptoms see specialists. Many are still being diagnosed by their family physicians, sometimes without the full battery of tests available. Since even specialists have to be very careful when making a diagnosis of Alzheimer’s disease, it would seem that a diagnosis made by a family practice doctor, based on some in-office tests, could be less than accurate. While it seems odd to me that people are still being diagnosed in this casual manner, given the fact that AD is a life-altering disease, I hear from people frequently that this is so.

A spokesman for the study, which was published online in the journal Brain: A Journal of Neurology, was quoted as saying, “We now proposed that micro-bleeds are an example of amyloid pathology meets vascular [blood vessel] damage,” because they represent blood vessel damage that occurs simultaneously with Alzheimer’s disease…”

I’m wondering – are micro-bleeds just part of Alzheimer’s because of their association with plaques? Or do people who have micro-bleeds become more prone to vascular dementia, as well? One can hope doctors are using the most sophisticated tests possible to accurately diagnose the type, or types, of dementia present, since there are treatments for some dementias that can slow symptoms. I hope to see more information on studies about micro-bleeds, as well as mixed dementias, in the near future. These studies could lead to better treatment.

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