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Brain screening answers questions,allays fears
Bill Crist was angry and upset when his doctor diagnosed him with dementia. But the 64-year-old retired pharmacist felt a little better after going to the Centre for Brain Health for an evaluation, which showed his language skills and memory were still quite strong. Crist suffers from a neurodegenerative disorder that is associated with the diseases Alzheimer's and Parkinson's. He said the follow-up test helped show him which brain functions "look normal." Such exams are becoming increasingly popular as ageing Americans try to differentiate between the normal problems associated with getting old and the effects of neurological conditions. The three-hour screenings cost US$350 and are not covered by insurance. Many people get tested even when they are not showing signs of brain problems. Dr Sam Gandy, a neurologist with the scientific advisory council of the Alzheimer's Association, said such screenings are "over and above what professional societies recommend." He said people worried about their memory might be better served by a briefer evaluation in their own doctor's offices. "People who want to have baseline tests of any sort are free to pay for them," Gandy said. "There was a rush for a while for people to pay for whole-body lab scans." George M Martin, professor emeritus of pathology at the University of Washington and the scientific director of the American Federation for Ageing Research, had a different view. "It's perfectly appropriate if a person has some anxiety - why not go in and have experts assess you?" The brain centre was founded in 1999 as part of the University of Texas at Dallas' School of Behaviour and Brain Science. As word has spread, the number of screenings has gone up sharply, said Jennifer Zientz, head of diagnostic services for the Centre for Brain Health. Last year the centre did 160 check-ups, compared with about 50 the previous year. Molly Keebler, the centre's head of community programmes, even had her 84-year-old mother tested after she noticed she had stopped doing some things she usually enjoyed, like keeping a journal. Her mother, Naomi Williams, got a clean bill of health, and some tips on how to stay sharp. She now keeps a notebook in her purse to jot down reminders and has kept up activities such as reading and going to movies. "The screening made me feel very uplifted," said Williams. Zientz said the screenings look at how people process complex information. For people like Crist, who already know they have dementia, the screening helps them focus on their mental strengths. The screening includes several verbal tests, such as interpreting and explaining proverbs. For example, a healthy person could easily interpret "Don't judge a book by its cover." But someone with cognitive problems might say it means you have to read a book to know what is in it. When problems are found in the screening, the centre refers the patient to a doctor. Slight downward shifts in mental capacity can be a sign of strokes, kidney malfunction, stress or depression, said Dr Sandra Chapman, the centre's director. "The earlier you detect a glitch in the brain, the more that can be done," she said. The best candidates for screenings are people who have noticed changes in their memory, said Dr Randolph Schiffer, chair of the department of neuropsychiatry and behavioural science at Texas Tech University. Dr Bill Woodfin, a Dallas neurologist, said the centre not only allows people to talk frankly about the challenges of memory loss, but also helps them understand how they can improve their memory. "I would anticipate more people in my position - physicians, psychologists who see people with these problems - will refer patients more frequently" for such tests, said Woodfin, who last year referred about six. On a much simpler level, the exam gives patients and their families some positive news during a difficult time. Crist's wife, Peggy, said the tests give patients something positive, rather than negative, to focus on. "I know it sounds hokey, but it's something you need when you get a diagnosis like that," she said.
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