Symptoms of Alzheimer’s disease can range from mild forgetfulness to life-altering changes in mental capabilities. These variants can pose significant challenges for the more than five million patients affected by this disease as well as for their health care providers. For example, the amorphous signs of the condition can create delays in diagnosis as other conditions associated with memory loss are ruled out.
“It’s often very hard to tease out what might be normal aging and what might be early signs of Alzheimer’s disease,” says Brent P. Forester, MD, Chief of McLean Hospital’s Division of Geriatric Psychiatry, Medical Director of Behavioral Health for Partners HealthCare’s Center for Population Health, and a specialist in the behavioral complications of Alzheimer’s and related dementias. “Primary care doctors don’t necessarily have the tools or comfort level with giving a diagnosis that is today a death sentence.”
The earlier the diagnosis, Dr. Forester explains, the more opportunity patients have to take medications that in some people slow the disease’s progress, or enroll in a clinical trial of an experimental drug. The current goal of Alzheimer's treatment is to maximize quality of life, engage individuals in meaningful activities, and take a holistic approach to enhancing brain function through social interactions, cognitive engagement, exercise, and nutritional approaches. Meanwhile, relatives can ensure that their loved one remains safe and isn’t left with responsibilities at odds with memory loss and behavioral difficulties, such as managing personal finances.
Massachusetts Governor Charlie Baker signed into law multifaceted legislation designed to enhance the diagnosis and treatment of this enigmatic disease on August 15, 2018, at the offices of the Alzheimer’s Association of Massachusetts and New Hampshire. The law requires physicians and other clinicians to undergo licensure training in diagnosis and care of patients with Alzheimer’s and related dementias. It stipulates that a family member or legal proxy must be notified of an individual’s Alzheimer’s diagnosis, and mandates that all hospitals in the state must develop and put into practice by 2021 a plan to recognize and manage patients with the condition.
The legislation is expected to enhance the medical community’s understanding of the disease, the way in which they approach patients—and the experience of patients themselves. Dr. Forester notes that more timely diagnosis can also help patients and families better plan for what could be a decade-long (or more) illness. He adds that the Center for Population Health will support Partners’ compliance with the new law by deploying a comprehensive dementia care initiative to help primary care physicians evaluate and manage dementia, and help support communication with patients and their families regarding diagnosis and care. That includes the facilitation of timely referral to specialty care when needed.
“Early diagnosis is critical to help families plan for treatment options that improve quality of life, reduce behavioral symptoms of dementia, and ease the caregiver burden associated with these conditions,” Dr. Forester adds. To read more about the landmark legislation, visit The Boston Globe.
Header image above, from left to right: Alzheimer’s Association of MA/NH Advocacy Associate Ayah Roda, Alzheimer’s Association of MA/NH Director of Public Policy Daniel C. Zotos, Chief of McLean Hospital’s Division of Geriatric Psychiatry and Medical Director of Behavioral Health for the Center for Population Health Dr. Brent Forester, family advocates Rhiana Kohl and her daughter, MA Governor Charlie Baker, Alzheimer’s Association of MA/NH Executive Director James Wessler, and Health and Human Services Secretary Marylou Sudders.