According to Alzheimer’s Disease International, one person, somewhere in the world, develops dementia every three seconds. It is estimated that, at this moment, approximately 50 million people around the world live with Alzheimer’s or a related type of dementia. Unfortunately, research shows that dementia and Alzheimer’s have a poor diagnosis rate – with only approximately 20%-50% of the cases being diagnosed in high income countries and 10% or less being diagnosed in low and middle income countries. And though there is no known cure, medication for Alzheimer’s can help with the symptoms and can delay the onset of the severe forms of the disease. Diagnosing Alzheimer’s in the early stages, therefore, is extremely important for the patients, but also for their caregivers.
What is Alzheimer’s disease?
Alzheimer’s is an irreversible neurodegenerative disease and the most common cause of dementia in older adults (being responsible for approximately 70% of the cases of dementia). It progressively affects the brain and, eventually, the patient develops memory and cognitive problems, up to being unable to carry out the simplest everyday tasks.
There is currently no specific test which can confirm that a patient has Alzheimer’s. The disease can only be accurately diagnosed with the help of a microscopic examination of the brain that is performed after death. But doctors can still diagnose the patients based on the symptoms they or their family members describe and on the results of a series of cognitive tests.
Memory loss is one of the first sign of dementia caused by Alzheimer’s. But damage in the brain of the patients with Alzheimer’s is considered to begin years before the first symptoms start to appear. For most people, the first symptoms appear in their 60’s, while signs of early-onset Alzheimer’s can begin even when the patient is still in his/her 30’s.
According to the National Institute of Aging (NIH), there are three stages of the disease, according to the severity of the symptoms:
Mild Alzheimer’s Disease – in this stage, the patients usually still appears to be healthy, but begins to have certain concerning symptoms:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Trouble handling money and paying bills
- Wandering and getting lost
- Losing things or misplacing them in odd places
- Mood and personality changes
- Increased anxiety and/or aggression
Moderate Alzheimer’s Disease – in this stage, supervision and care may become necessary, as the symptoms evolve:
- Increased memory loss and confusion
- Inability to learn new things
- Difficulty with language and problems with reading, writing, and working with numbers
- Difficulty organizing thoughts and thinking logically
- Shortened attention span
- Problems coping with new situations
- Difficulty carrying out multistep tasks, such as getting dressed
- Problems recognizing family and friends
- Hallucinations, delusions, and paranoia
- Impulsive behavior such as undressing at inappropriate times or places or using vulgar language
- Inappropriate outbursts of anger
- Restlessness, agitation, anxiety, tearfulness, wandering—especially in the late afternoon or evening
- Repetitive statements or movement, occasional muscle twitches
Severe Alzheimer’s Disease – in this stage the patients can no longer communicate and are totally dependent on their caregivers. By now, the symptoms have significantly worsened:
- Inability to communicate
- Weight loss
- Skin infections
- Difficulty swallowing
- Groaning, moaning, or grunting
- Increased sleeping
- Loss of bowel and bladder control
What is very important to know is that while dementia is more common in older people, it is definitely not a normal part of aging. Therefore, if you experience any of the above symptoms, you should get in touch right away with your healthcare provider for a complete evaluation.
The peanut butter test for detecting Alzheimer’s
This test was first described in the study titled “A Brief Olfactory Test for Alzheimer’s Disease”, which was published in 2014 in the Journal of the Neurological Sciences. Since then, the test has drawn a lot of media attention, but also quite a volume of criticism from other researchers. The study’s lead author, Jennifer Stamps, said that she based this study on the idea that the sense of smell is dependent upon the olfactory nerve, which is one of the first things to be affected by cognitive decline. The test consists in measuring the patient’s ability to smell peanut butter through each nostril and using the results to detect Alzheimer’s disease.
The assumption was that patients with Alzheimer’s would not be able to smell the peanut butter as well through their left nostril as they would through their right nostril; that is because, in the early stages of Alzheimer’s disease, the grey matter volume loss and temporal lobe atrophy are considerably more pronounced on the left side of the brain. And the results confirmed it: a left nostril impairment of odor detection was present in all the patients with probable Alzheimer’s disease. Stamps concluded, therefore, that “this non-invasive and inexpensive left-right nostril odor detection test appears to be a sensitive and specific test for probable AD (Alzheimer’s disease).”
Why peanut butter?
Stamps was administering peanut butter to patients as a part of a routine test for cranial nerve function, when the idea for the peanut butter Alzheimer’s test begun to take shape. Peanut butter is considered to be a “pure odorant”, meaning that it can only be detected by the olfactory nerve.
A word of caution
Though this study is interesting and really promising, by no means does it imply that this test is a tool patients can use at home to self-diagnose. Alzheimer’s disease is a very complex condition and only your healthcare provider can offer proper guidance for a correct diagnosis.