Amsterdam: Alzhei­mer’s disease experts are revamping the way doctors diagnose patients with the progressive brain disorder — the most common type of dementia — adopting a seven-point rating scale based on cognitive and biological changes in the patient.

The new guidelines, unveiled by experts on Sunday in a report issued at an Alzheimer’s Association conference in Amsterdam, embrace a numerical staging system assessing disease progression similar to the one used in cancer diagnoses. They also eliminate the use of terms like mild, moderate and severe.

The revamp — replacing guidelines issued in 2018 — was prompted by the increased availability of tests detecting key Alzheimer’s-related proteins such as beta amyloid in the blood and new treatments that require confirmation of disease pathology prior to use.

The 2018 guidelines, which were intended for research use, incorporated existing technologies for detecting Alzheimer’s proteins based on PET scans of the brain and tests of cerebrospinal fluid, which were only accessible via a lumbar puncture. Such tests were costly and not typically used in standard medical practice.

The new system is designed to be more accurate and better reflect a person’s underlying disease, according to Dr Clifford Jack of the Mayo Clinic in Rochester, Minnesota, lead author of the report sponsored by the Alzheimer’s Association and the National Institute of Aging, a part of the US government’s National Institutes of Health.

The change comes at a time when doctors are preparing to identify and treat patients with Eisai and Biogen’s drug Leqembi, which won Food and Drug Administration approval this month, and Eli Lilly’s experimental drug donanemab, which is now under FDA review.

Published in Dawn, July 17th, 2023