Listen Up

Friday, April 5, 2019

Crisis at the Border, Volunteer Doctors Struggle To Provide Stopgap Care To Immigrants | Kaiser Health News


It wasn’t the rash covering Meliza’s feet and legs that worried Dr. José Manuel de la Rosa. What concerned him were the deep bruises beneath. They were a sign she could be experiencing something far more serious than an allergic reaction.





Besides the obvious, the doctor wonders "Has this child been immunized"? What other illnesses could the child have had, and what is he now carrying?

The doctor is also thinking about the possible hundreds of children who are not being vaccinated due to the false myth that vaccination causes autism.  Vaccination for mumps, measles, rubella, polio and other diseases we rarely encounter in the United States.




 In the absence of a coordinated federal response, nonprofit organizations across the 1,900-mile stretch have stepped in to provide food, shelter and medical care. Border cities like El Paso, San Diego and McAllen, Texas, are used to relying on local charities for some level of migrant care. But not in the massive numbers and sustained duration they’re seeing now. As the months drag on, the work is taking a financial and emotional toll. Nonprofit operators are drawing on donations, financial reserves and the generosity of medical volunteers to meet demand. Some worry this “new normal” is simply not sustainable.

Dr. José Manuel de la Rosa writes a prescription at a makeshift clinic in an old warehouse in El Paso.


Why the crisis and danger?  The number of California children granted medical exemptions from vaccinations has tripled in the past two years.

Recently there have been sporadic cases of a polio-like syndrome with paralysis from an entero-viral illness (diarrhea, stomach cramps). Many migrant children have diarrheal illnesses when they arrive and by the time they are interred in refugee camps with poor hygiene and crowded facilities they have become a breeding ground.  Measle has reappeared as well. 


The current immigration problem has largely been ignored as a public health crisis. Immigrants come from a totally different immune environment. When North America was repopulated by Europeans the native Americans were decimated by new diseases were incapable of fighting. Of course, at that time the biologic diversity between Europe and a New World was far greater than migrants from Central America. (or is it?)








On The Border, Volunteer Doctors Struggle To Provide Stopgap Care To Immigrants | Kaiser Health News: As recent arrivals are released from detention with severe medical problems ranging from diarrhea to gaping wounds, a makeshift health system of volunteers is overwhelmed. The work is taking a financial and emotional toll.

Thursday, April 4, 2019

The Epidemic of Stem Cell Treatment:


Elite Hospitals Plunge Into Unproven Stem Cell Treatments



A possible public health issue is growing across many states.

Credible physicians and researchers are performing clinical trials in accordance with FDA guidelines for clinical trials.  This will require some years of trials for the FDA approves this therapy.

One such institution is the Mayo Clinic's Center for Regenerative Medicine, headed by Dr. Shane Shapiro, Assistant Professor of Orthopedic Surgery and Program Director for the Regenerative Medicine Therapeutic Suites. His research is guided by the Food and Drug Administration's Clinical Trials protocol.



There are other ongoing studies at the Cleveland Clinic, University of Miami, and other respected Hospitals.

Ongoing early studies of stem cells are ongoing and in most cases, the results are in peer-reviewed journals, but not yet ready for clinical use.

Most stem cell clinics post unproven benefits of stem cell injections. The online video seems to promise everything an arthritis patient could want.   The doctor says regenerative medicine can help heal chronic pain while avoiding surgery. Stem cells are not a medicine or a drug. It is a biologic pharmaceutical.

Anyone considering stem cell injection must use extreme caution, and find several reference sources...Usually, this would be a University Medical Center. Patient testimonials are fraught with errors.

Stem Cell information from National Institutes of Health
Where do Stem Cells come from?


Regenerative medicine (stem cell) research is rapidly evolving and some printed information may already be obsolete. The jump on the bandwagon desire to obtain the most recent "breakthroughs' are often premature and potentially dangerous.



Opinion/Commentary: Stem cell treatments for arthritic knees are unproven





Elite Hospitals Plunge Into Unproven Stem Cell Treatments | Kaiser Health News: Critics are concerned about the explosion in controversial stem cell procedures offered by clinics — and, increasingly, respected hospitals.

UC Davis alerted 200 people about March 17 measles exposure |

UC Davis Health said Wednesday they sent out roughly 200 letters to people who may have been exposed to the highly contagious measles virus March 17 in the emergency department at UCD Medical Center. A young girl taken care of there was diagnosed with the illness.
The letter from UC told recipients: “You will need to notify your primary health care provider(s) and your child’s provider(s) of this possible exposure to discuss your possible risk of infection, vaccination history, and other questions you may have.”

In its early stages, the measles virus is often mistaken for a respiratory illness, public health officials say, and that is particularly true during the flu season when so many people are showing up to emergency rooms and doctor’s offices with influenza. Measles typically starts with a mild or moderate fever; cough; runny nose; and red, watery eyes. The telltale symptom of the disease is a red rash that eventually covers most of the body, but it does not appear for several days after symptoms start.
If you have been exposed to measles or have been traveling abroad and return with flu-like symptoms, doctors recommend you call ahead to your medical provider and provide that information. That way, they said, the staff can make arrangements to bring you in through a more isolated route.

Measles was just about eliminated by vaccination. Recently unfounded concerns about increasing rates of autism caused anxiety among some parents. Scientific evidence disproved this popular idea. A groundswell of anti-vaxxers convinced some to stop vaccinating their children.  An entire political philosophy of freedom and rights caused many naive people to believe this fake news.

Most parents have never seen a case of measles, and that may also be true of some physicians.  Like Polio and Smallpox measles was of historical interest. 


A scanning electron microscope photo of measles virus



Rubella or German Measles is often confused with Rubeola (Measles).


German measles is dangerous for pregnant women, since it causes birth defects, hearing loss in their babies.  MMR vaccine is a combination vaccine for Mumps, Measles and Rubella.

Any disruption or decrease in the vaccination pool leads to sporadic outbreaks. The virus is highly contagious and spreads via the respiratory route.  One sneeze in a public space can cause a mini-epidemic.  People in the early stages of measles have no symptoms, and no rash.  Prevention by vaccination is critical, because there is no treatment for active disease, other than fluids, cooling and analgesics.


Infected individuals can have measles for up to five days before showing symptoms, but most people will start have symptoms within 12 days. However, they can transmit the virus for days before symptoms appear. They do so by coughing molecules into the air or into their hands, where they can be spread to others. Medical officials say that the virus aggressively attacks immune systems and that exposure to even a few droplets with the virus can make people sick.
The measles vaccine is a safe and effective way to prevent the illness, doctors say. California law requires students to be vaccinated before entering school, unless parents have a medical exemption for their children. Measles can cause deafness and death.



Without vaccines, measles can be costly to prevent and treat. That’s because children – and even some adults – with the disease often have to be hospitalized for care and because public health departments have to pull many staff members from other work to identify and isolate people exposed to the virus.








UC Davis alerted 200 people about March 17 measles exposure | The Sacramento Bee

Wednesday, April 3, 2019

Death By A Thousand Clicks: Where Electronic Health Records Went Wrong



Has electronic health record improved the quality of health care?  Physicians, nurses, and others say a resounding NO.

There is a multitude of reasons:

1. Poor interface design, difficult to use, non-intuitive
2. Decreased workflow, fewer patients served.
3. Maintenance costs.
4. Information overload.
5. EHR does not follow the normal clinic workflow requiring workarounds.
6. The electronic health record is designed more like an accounting system, presenting non-relevant information, overloading the user's ability to focus on important data.

FDA Guidance has published information relevant to the design of electronic health records, however, it is generic and poorly focused on the relevant issues, and contains no reference to the quality of the content or usability.

The term 'meaningful use' is an oxymoron because it does not pertain to it's use by users, physicians, hospitals and others.



Early financial incentives brought to market inadequate and poorly designed electronic health records. The federal incentives were designed to enforce compliance with the collection of data, outcome studies rather than the effectiveness of health care using electronic health records.

Raj Ratwani (standing) studies eye-tracking with Dr. Zach Hettinger to see how doctors interact with EHRs.

Analysis of EHR acquisition is misleading. It is largely driven by incentives and a 'jump on the bandwagon' mentality which is directly opposite of how providers adopt new treatments or technology. ie, a technology doomed to fail.

Office adoption of EHR


Hospital adoption of EHR



Why Thousands of Doctors Still Don't Use Electronic Records

Electronic Health Record vendors struggle also to account for errors due to electronic health records and have implemented measures for reporting critical errors using Maude. Even that is highly flawed. Looking at their web site one can see it too is an overwhelming overload of nonrelevant information designed to 'account' rather than report. What physician or hospital would or could use it?

Others have turned to social media to vent. Dr. Mark Friedberg, a health-policy researcher with the Rand Corp. who is also a practicing primary care physician, champions the Twitter hashtag ­#EHRbuglist to encourage fellow health care workers to air their pain points. And last month, a scathing Epic parody account cropped up on Twitter, earning more than 8,000 followers in its first five days. 
















Death By A Thousand Clicks: Where Electronic Health Records Went WrongKaiser Health News: Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

Tuesday, April 2, 2019

CalHealthCares loan repayment program now accepting applications




It is a new day.  Student loans are creating a situation where medical students and others are left with 100,000 of dollars which they must pay back. In some cases, it amounts to a mortgage requiring 15 years or more to pay.  While some of the arrangements allow for low payment, it may still be a problem which can affect the ability to purchase an automobile or obtain a mortgage to purchase a home.




Some professional or advanced degree programs can extend for four to eight years.

During the last ten years, student debt has soared., while debt for automobiles and credit card has decreased.



There are many loan forgiveness programs, including those for specific jobs, locations, public service positions, and others. Each state or locale has repayment programs, such as the California healthcare loan repayment program for physicians who agree for a set period to treat California's Medii-caid program. This dovetails well with the shortage of physicians willing to accept Medicaid payments due to low Medicaid reimbursements


The rate of college tuition and fees has accelerated beyond the increase of median family income.


In order to mitigate some of this effect, a cap is now in effect for loans



AARP explains the impact of student loan debt extending into the life of senior citizens

The number of people over 60 with outstanding student loans has quadrupled in recent years



The true cost of a student loan and it's payback period is far in excess of the loan amount.

AARP recomends several means of accommodating loan debt.


Consider loan consolidation

If you're currently in repayment and you have multiple student loans, you may get financial relief by consolidating your student loans into one smaller, more affordable payment.
This gives you some economic breathing room. However, the trade-off is that loan consolidation extends the life of your loans, so you pay more interest in the long run.
Depending on what type of student loans you have (private or federal), your options for consolidating your loans into a single loan will vary.

Sign up for flexible repayments

If you have federal student loans, Uncle Sam offers a variety of loan repayment options that take into account your income, family size and other factors.
The income-driven repayment plans now available include an income-based repayment (IBR) plan, income-contingent repayment (ICR) plan, Pay as Your Earn (PAYE) repayment plan and the Revised Pay as You Earn plan, better known as REPAYE. The latter plan caps your student loan repayments at a maximum of 10 percent of your income, depending on when you took out the loan.

Get a loan cancellation if you qualify

In 2015, more than half of the 114,000 older borrowers who were subjected to garnishment of their Social Security checks were receiving Social Security disability benefits rather than Social Security retirement income, the GAO found.
However, nearly one-third of older borrowers who had defaulted were ultimately able to get rid of their college debt by obtaining a total and permanent disability discharge, the GAO reported.
A disability discharge is a loan cancellation that's available to borrowers with a disability that is not expected to improve. If you qualify, your loans could be written off entirely, but you will have to provide annual documentation about your income to federal authorities.
Lynnette Khalfani-Cox, the Money Coach, is a personal finance expert, television and radio personality, and regular contributor to AARP.org. You can follow her on Twitter and on Facebook.



CalHealthCares loan repayment program now accepting applications: The program incentivizes physicians to provide care to Medi-Cal beneficiaries by repaying educational debt up to $300,000 in exchange for a five-year service obligation.

Monday, April 1, 2019

The community-focused family medicine clinic: A “new model” in Oregon

During a time of tremendous change in medicine and health care in which no one is very happy do your want to be swept along with the 'pied pipers" of Medicare, HMOs, Private Insurers and the rest of the lot. My answer is NO! and there are many successful physicians and their Happy Patients doing their own thing and spending much less to stay healthy.



How would you like an hour with your doctor?   Really? Is this a scam?

How can we do that? These are all reasonable questions.  Read on, let me explain.

by Pamela Wible, M.D.  The Ideal Medical Clinic

"Six months ago I embarked on a quest to develop a health care model that would truly serve our community. I had an epiphany that involving the community in the creation of the clinic would be integral to the success of the venture. In neighborhoods and community centers throughout the region, I facilitated public forum discussions on the “Ideal Medical Clinic.” All participants were encouraged to express their wildest dreams and most creative visions in roundtable discussions that were remarkably lively, providing fertile material for the birth of our true community-based medical practice. Just 1 month later, 90% of the community input was incorporated into a fully functioning solo “Family and Community Medicine Clinic.” Concurrent with my venture to create the ideal medical practice locally, the Future of Family Medicine (FFM) project has spearheaded a national campaign, a call to action for family physicians to create a new model of family medicine. After substantial research, the FFM project determined the characteristics of the “New Model” of family medicine: • a personal medical home • patient-centered care • whole person orientation • team approach • elimination of barriers to access • advanced information systems **"



If you want this type of medical care...engage and own it. Start your own Ideal Medical Clinic


The Future of Family Medicine: A Collaborative Project of the Family Medicine Community



Physician Suicide Letters Answered Paperback – January 11, 2016

Pet Goats and Pap Smears



What do you really need?

Not much. The Chamber of Commerce, local business, City Council, One generous philanthropy.

BE BOLD, GO WHERE NO MAN HAS GONE BEFORE (except Dr Wible and a few hundred others. (probably thousands by now)

 





JFP_0805_Observ.finalREV

Thursday, March 28, 2019

Estrogen Therapy Boosts Transgender Women's Brains


Taking estrogen after gender-affirming surgery improves brain connections key to memory, learning, and emotion in transgender women, a new study finds.
Not only does this suggest that trans women should keep up hormone therapy post-op, but it also underscores the deep connection between hormones and brain connectivity.
After having bottom surgery, removing the testicles, trans women experience the same symptoms that post-menopausal women do, such as hot flashes and night sweats.
The discovery, made by scientists at McMaster University in Ontario, Canada, and at the Hospital de Clínicas de Porto Alegre in Brazil, suggests that estrogen therapy may benefit the brains of trans women and post-menopausal women alike.
As research advances, we are discovering more and more how central hormones are to many physical processes - and how interconnected these systems are.
The hormone or endocrine system plays a key role in instigating everything from how we process food to how stress affects the body and even our heartbeats.
And the new research sheds light on how sex hormones affect the brain, too.
For trans women, gender-affirming surgery can do wonders to dispel lifelong dysphoria, in turn improving mental health and overall quality of life.
As the trans community and trans issues are finally becoming more socially accepted, doctors have seen a swell in the number of people seeking and having gender-affirming operations.
In the case of trans women, a complete transition means removing the testicles and penis - and with them the production center for male hormones.

Orchiectomy for Transgender Women: What to Expect  Warning, this link contains explicit diagrams.

Prior to surgery, many trans women take estrogen - in addition to testosterone blockers and progesterone, in many cases - to encourage their transition.
These hormones have a four-part effect on trans women's bodies and minds.
An infusion of estrogen, coupled with falling testosterone levels, can alter the way a trans woman senses and feels things, redistribute fat, trigger breast growth, change the skin, may trigger the emotional roller coaster of simulated puberty, change hair growth, sex organs and sexuality and more.
There are two categories of fairly clear but poorly understood effects of hormone therapy's effects on the brain: the quick change in how women perceive sensory information and in the emotional changes that some trans women experience.
But the new study reveals one of the mechanisms that may be at play - namely, communication between brain regions through the thalamus.
The researchers recruited 18 transgender women who had undergone complete transition surgeries, including the removal of testicles, stopping their male hormone production.
They all went off the estrogen therapies they'd taken before surgery for a month, were given MRIs to asses their brain activity, then resumed estrogen.
After another two months (60 days), they underwent another MRI.
The researchers saw that, while the women were on estrogen, a region of the brain called the thalamus was much more active...................more
This finding is a great advance for the neuroendocrinology sciences,' said lead researcher Dr. Maiko Abel Schneider of McMaster University in Hamilton, Ontario, Canada.
http://tinyurl.com/y46wgwpu

Wednesday, March 27, 2019

Virtual Medicine Conference


About the Course Director

Brennan Spiegel, MD, MSHS, is Director of Health Services Research for Cedars-Sinai Health System. He directs the Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), a multidisciplinary team that investigates how digital health technologies – including wearable biosensors, smartphone applications, and virtual reality – can strengthen the patient-doctor bond, improve outcomes and save money. Dr. Spiegel has published numerous best-selling medical textbooks, editorials and more than 170 articles in peer-reviewed journals. He is listed in the Onalytica "Top 100 Influencer" lists for digital health (No. 13) and virtual reality (No. 14). His team's digital health research has been featured by major media outlets, including Bloomberg, the Boston Herald, Forbes, Huffington Post, LA Times, Mashable, NBC News, NPR, PBS, and Reuters. His virtual reality research won the 2017 “Webby Award” for best technology on the internet.

Good morning.  Today's post is a live stream from Cedar's Sinai Medical Center. It is in a virtual reality setting sponsored by Samsung VR.  If you have a headset put it on.  If not you can still see the VR stream live and look throughout the conference room.



Not so far in the future, doctors might prescribe a virtual beach vacation to calm aches and pains, in lieu of taking a pill. Insurance companies might offer scenic tours of Icelandic fjords to lower blood pressure, instead of doubling up on drugs. Psychiatrists might treat social phobia by immersing patients in a virtual dinner party.

It’s starting to happen right now because of virtual reality – the mind-bending technology that offers immersive, multisensory environments that nudge our brains into thinking we are somewhere else.

Virtual Medicine is a two day symposium that convenes the brightest minds in therapeutic VR. Attendees learn from case studies, didactic lectures, patient vignettes, and VR demos.


Virtual Reality is beginning to impact treatment protocols. There are many clinical studies in progress.






Today's presentation Virtual Medicine Conference an excellent presentation focused mostly on behavioral health and presented as a new medium for treating pain, anxiety, depression and other neuropsychiatric disorders. Other possible uses are for phobias, PTSD, Addiction, Acute anxiety disorder, and others.

Virtual Reality in Medical Education


The use of VR in Surgery for teaching and patient education

VR taken individually offers a breakthrough for all these applications.  When coupled with artificial intelligence and bots (automatic chats) for questions and answers it offers an exponential gain in treatment for remote diagnosis and conversation with patients.

Monday, March 25, 2019

A “robot” doctor told a patient he was dying. It might not be the last time. - Vox

This is the future of care for many patients with limited access.

The rapid influx of advanced technology is changing the practice of medicine — at times for the better, but sometimes for the worse. Nowhere is this more apparent than a story where a physician told a fatally ill man in a Fremont, California, hospital that he was dying via video chat on a screen attached to a robot. The news should serve as a wake-up call to the medical establishment on the limits of technology.

The patient, 78-year-old Ernest Quintana, was sitting in his hospital room when a “telepresence robot” — or a mobile robot with a video screen that live-streams a physician in another location — rolled in and informed him that there was nothing that could be done to treat him. Quintana, who had chronic obstructive pulmonary disease, was with his granddaughter and a nurse when he was told his options for managing pain at the end of his life. The granddaughter, shocked at this bombshell dropped from a disembodied robot, filmed part of the encounter, which subsequently went viral online. Mr Quintana died the following day.


The fact that a patient and their family member were delivered devastating news via a telepresence robot is a rightfully shocking episode that runs counter to much of what many of the prophets of the digital revolution in medicine have been preaching. It has confirmed the worst fears of many patients and doctors that technology might increase the distance between physicians and patients during their most vulnerable moments. As a cardiologist training in advanced heart failure who frequently has such conversations with patients — and knowing just how complex and emotionally fraught these moments can be — I am not surprised that the patient and his granddaughter reacted with horror.
Yet a knee-jerk reaction may distract us from looking at the big picture. Just like any medical technology, digital health can be an excellent tool for better, patient-centered care. But it also comes with risks that could erode the practice of medicine, especially for patients who might already have limited access to health care resources and physicians.  However, we cannot allow digital health to take over, it remains one more tool in treating patients, not an endpoint.
The human factor cannot be denied. A cold unfeeling machine is not the same even though a human face is present. Even with a two way video feed certain emotions are not palpable.

A patient expects a human being with whom to interact, either good news or bad news. Technology, artificial intelligence will not replace 'presence'. Even virtual reality probably cannot replace the physical presence of a physician or nurse.

Many in the public and the physician community are skeptical about whether the digital health revolution can bridge the gap between patients and doctors. While I consider myself one of the cautious optimists, the fact is that the way our current health system is designed — and, especially, how we pay for it — digital health innovations could very well stretch the widening gulf between patients and their doctors.
Given that our health system continues to reimburse based mostly on the volume of medical services delivered rather the quality of the care or the patients’ experience, technology will only be deployed so that health systems squeeze their physicians and nurses for every last dollar they can eke out of them. And if the doctor shortage in America’s rural areas continues, scenes such as the one in Mr Quintana’s room may be repeated in the lowest-income communities.
The reason I remain hopeful is actually because of another important side of Mr Quintana’s story. Earlier in the day, a female physician, who was described by the granddaughter as “very sweet,” visited the patient. The content of what this physician said was very similar to what the robo-doctor said, but there was an important difference. She held his hand, explaining the same grim news in a much more humane way.













A “robot” doctor told a patient he was dying. It might not be the last time. - Vox:

Sunday, March 24, 2019

Eye Exam Detects Signs of Alzheimer's Disease

The new research is a "small step forward," said Dr. Richard Isaacson, director of the Alzheimer's Prevention Clinic at NewYork-Presbyterian/Weill Cornell Medicine.
"But future studies need to focus on earlier stages of the disease," Isaacson said in an email. "We already have more definitive ways to diagnose dementia due to Alzheimer's, but we need to see if OTCA can be a useful cost-effective screening test for pre-symptomatic Alzheimer's."
 Using an ultrasensitive scanning technique, researchers can detect signs of Alzheimer's disease in the tiny blood vessels at the back of the eye, according to a new report.
Duke University researchers found that these small retinal blood vessels were altered in patients with Alzheimer's disease, but in not in those with mild cognitive impairment (MCI) or those with no signs of mental decline.
"Among the folks who had Alzheimer's there was a significant reduction in the density of the blood vessels in the superficial layer of the retina compared to controls and those with mild cognitive impairment," said Dr. Dilraj Grewal, an associate professor of ophthalmology at the Duke Eye Center. "We also found a reduction in the thickness of (of a specific layer of the retina) in Alzheimer's patients compared to controls and those with mild cognitive impairment."
The findings were reported March 11 online in Ophthalmology Retina, a publication of the American Academy of Ophthalmology.
"The retina is an extension of the brain," Grewal said. "And it's thought that changes that occur in the brain are mirrored in the retina. With any neurodegenerative disease, you lose nerve tissue. Along with a measurable loss of brain volume, there's a loss of the vasculature that supplies the brain. And because the retina is part of the central nervous system, the same changes occur there."

Practical Essentials


The current diagnosis of Alzheimer disease is made by clinical, neuropsychological, and neuroimaging assessments. Routine structural neuroimaging evaluation has long been based on nonspecific features such as atrophy, which is a late feature in the progression of the disease. More recently, a variety of imaging modalities, including structural and functional magnetic resonance imaging (MRI) and positron emission tomography (PET) studies of cerebral metabolism, have shown characteristic changes in the brains of patients with Alzheimer disease in prodromal and even presymptomatic states. [123]
Alzheimer disease was first described in 1907 by Alois Alzheimer. From its original status as a rare disease, Alzheimer disease has become one of the most common diseases in the aging population, ranking as the fourth most common cause of death. Alzheimer disease is a progressive neurodegenerative disorder characterized by the gradual onset of dementia. The pathologic hallmarks of the disease are beta-amyloid (Aβ) plaques, neurofibrillary tangles (NFTs), and reactive gliosis. [456(See the images below.)
fMRI revealing changes from Alzheimers Disease

Left Healthy Brain Right Alzheimer Brain  
                          

Coronal, T1-weighted magnetic resonance imaging (MRI) scan in a patient with moderate Alzheimer disease. Brain image reveals hippocampal atrophy, especially on the right side.

Eye Exam Detects Signs of Alzheimer's Disease: Using an ultrasensitive scanning technique, researchers can detect signs of Alzheimer's disease in the tiny blood vessels at the back of the eye, according to a new report.
Retinal fundus photography

Retina Fundus Camera

Using a high-definition eye scan developed especially for the study, researchers detected the crucial warning signs of Alzheimer's disease: amyloid-beta deposits, a buildup of toxic proteins. The findings represent a major advancement toward identifying people at high risk for the debilitating condition years sooner.
In addition to retinal imaging, there may be other ocular findings associated with Alzheimer's disease.
Low levels of amyloid-β and tau proteins, biomarkers of Alzheimer's disease (AD), in eye fluid were significantly associated with low cognitive scores, according to a new study published in the Journal of Alzheimer's Disease. Led by researchers at Boston Medical Center, the study is the first to connect these known AD protein biomarkers in the eye to mental status. These findings indicate that proteins in the eye may be a potential source for an accessible, cost-effective test to predict future Alzheimer's disease.

https://www.hindawi.com/journals/joph/2018/8538573/

https://www.ncbi.nlm.nih.gov/pubmed/25095818

https://www.sciencedirect.com/science/article/abs/pii/S0304394007002492