This paper will present a broad overview of brain aging and the predictors of MCI and AD. A first step is differentiating aging and getting older. The focus will be on the tools and the hypotheses which are most useful in predicting and/or preventing clinically and socially significant deterioration of functioning in the elderly.
Everyone, including me, looks at brain aging, getting older, and the development of MCI and Alzheimer’s Disease from the perspective of their personal background and the tools they are comfortable using. (Give a child a hammer, and everything is a nail). The question is: What tools are most useful in studying brain aging, MCI and Alzheimer’s Disease (AD). All are helpful, is one better?
Genetic tools and studies have certainly identified some genes that in some people increase the risk of developing AD. But, as we all know, the relationship between genetic probability and clinical fact is far from perfect.
Imaging studies may offer hope for a way to monitor the development of Brain Aging, MCI, and AD before clinical signs appear. However, a review of imaging literature from 1996-2001 found that a clinical exam was more useful than imaging tests in predicting treatment outcome. Recent reports may have overcome these failings and this entire issue of the value of imaging verses clinical exam will be discussed.
A major question is: can the development of MCI/AD be prevented? The answer to that is, perhaps. The next question is: How? We know that vigorous mental activity in the elderly can decrease the probability of AD. There may also be some pharmacological agents that will slow or prevent MCI/AD.
The Nun’s study and the Scotland study provide strong evidence that intelligence and linguistic ability in early life--as young as 11 years of age--can predict AD. A discussion of these issues will form the basis for the bulk of this talk.
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