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Groundbreaking New Study Establishes Critical Need for Early Brain Health Checkup in Primary Care Facilities

New Test To Detect and Measure Progression of Dementia


News provided by

Eric Braverman, M.D.

Mar 20, 2013, 08:00 ET

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NEW YORK, March 20, 2013 /PRNewswire/ -- Brain health checkups may delay the development of dementia, according to a study published today in the journal, PLoS ONE. Neuroresearchers have found a new cost-effective option for primary care offices that validates low PET brain metabolism - an early marker of dementia.

A majority of individuals have an average brain speed of 300 milliseconds (msec) + their age (i.e., a 40-year-old has a brain speed of 340 msec) or P300, the test that measures brain age and waves. Individuals with brain speeds slower than 340 msec show progressive signs of cognitive decline and low brain metabolism on PET scan (Positron Emission Tomography). A healthy brain is at its peak performance processing information at 300-320 msec. Loss of even 4/100 of a second or brain speed slower than 340 msec correlates to lowered brain performance and cognitive decline. Most people lose 7-10 msec of brain processing speed per decade after age 40. For example, untreated patients from ages 80 to 100 have a brain speed of 380-400 msec, leaving them with some type of advanced dementia or MCI. The loss of brain processing speed is the best marker of memory and attention decline and the P300 is as easy to perform as an EKG or cholesterol blood test.

Just like cardiac function is routinely assessed in primary care settings, the new brain health checkup should be ideally implemented for in-office use to measure early signs of dementia 20 years before it begins in order to save Baby Boomers' continued function and productivity.

Lead author and former research partner of the New York State Commissioner of Health Nirav Shah, Eric R. Braverman, MD, points out that dementia typically begins between ages 70 to 80, with a 20 to 30 year prodromal illness starting from ages 40 to 50 called mild/moderate cognitive impairment (MCI). According to Braverman, "Diagnosis and treatment of MCI in a primary care setting may prevent and delay or potentially end the development of dementia."

Decline in brain speed delays or gaps between thought and action are measured with the Test of Variables of Attention (TOVA), which measures basic brain functions including complex attention, psychomotor processing speed, and reaction time. Typically, those ages 40 to 50 have subtle changes on an array of brain tests (i.e., P300 (Brain Electrical Activity Mapping), TOVA, Wechsler Memory Scale-III, CNSM, etc.), which may lead to dementia. The earliest sign of impending cognitive decline was found to be a gap between thought and action, which is reflected in the delay of this conversion of thought processes to action.

Diagnosis of the early stages of dementia, including Alzheimer's disease in primary care settings has been unreliable. Evidence presented in the published article emphasizes the importance of slow brain speed (P300) and the delay of attention or action (TOVA). According to PATH Foundation NY, there is a series of cost-effective neuropsychological tests, some taking only 15 minutes to complete that can measure brain age or speed of thought.

Mark Gold, MD, Chairman of the Department of Psychiatry at the University of Florida, suggests, "Additional tests such as Magnetic Resonance Imaging and Angiogram (MRI/MRA) and others can provide further support for this new in-office model."

Brain health checkups in primary care will ultimately help diagnose cognitive decline long before symptoms become clinically evident, thus at an earlier stage of disease. The earlier cognitive decline is identified, the earlier treatments can be initiated to slow progression of disease and pave the way for millions to reverse the early stages of dementia with hormones, pharmaceuticals, nutrition and lifestyle changes. Authors of the study believe that no medical office in the United States is properly equipped without brain health checkups. These tools will provide early intervention steps that will ultimately have a positive impact on chronic brain-related diseases (i.e, obesity, depression, anxiety, insomnia, violence, addiction, etc.) afflicting millions.  According to the Alzheimer's Association, dementia including Alzheimer's disease has cost the United States $200 billion annually and parallels obesity and smoking as one of our most expensive health care problems. Menopausal women are increasingly affected by mild/moderate cognitive impairment, which includes both memory and attention losses. Partial dementia once identified and reversed through treatment, between ages 40 to 70, will increase the years of effective work, thus reducing the financial burden on Medicare.

Eric Braverman, M.D. is the Founder and President of PATH Foundation NY, current Assistant Professor of the Department of Psychiatry at the University of Florida College Of Medicine and the McKnight Brain Institute and previous Assistant Professor in the Department of Neurosurgery at Weill Cornell Medical College during 2008-2012. He is also Director of PATH Medical.

Marlene Oscar Berman, Ph.D. is Professor of Anatomy & Neurobiology, Psychiatry, and Neurology (Neuropsychology) at Boston University School of Medicine. She is also Director of the Laboratory of Neuropsychology and Director of the Behavioral Neuroscience Ph.D. Program. Dr. Berman was honored with the MERIT Award from the National Institute on Alcohol Abuse and Alcoholism. This research was funded by NIH Grant NIAAA (R01 AA07112, K05 AA 00219) and from the Medical Research Service of the US Department of Veterans Affairs.

Kenneth Blum, Ph.D. is Scientific Director of PATH Foundation NY. He is currently Full Professor of the Department of Psychiatry and the McKnight Brain Institute at the University of Florida College of Medicine and Professor of Psychiatry, Center for Clinical & Translational Science, University of Vermont College of Medicine.

SOURCE Eric Braverman, M.D.

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