Dr. Khatib became personally familiar with the trauma of having a loved one misdiagnosed with Alzheimer’s disease. “I’ve seen first-hand how easy it is to receive a misdiagnosis of Alzheimer’s,” said Dr. Khatib.
Georgianna (Mrs. Khatib) suffered from a cognitive disorder that led to a diagnostic procedure administered through her routine health care providers. The result was a diagnosis of Alzheimers Disease, and standard Alzheimer’s treatment and medicines were prescribed for her treatment.
Dr. Khatib was not satisfied.
He feared that Alzheimer’s might be taking on the role of “default diagnosis" in Georgie’s case, and perhaps in other cases when no other cause for the patient’s disability has been found. So he concluded that before accepting the diagnosis, a full neurological consultation, likely to include additional testing procedures, should be applied to refine Georgie’s diagnosis. When a patient’s financial resources are limited and expensive testing may be involved, it may be true that the patient’s insurance company may be reluctant to authorize coverage for such testing, due to the expense involved.
So Dr. Khatib met any out-of-pocket costs involved, and In Georgie’s case, when neurological consultation and further testing was done, it was revealed that Alzheimers was an incorrect diagnosis. The consultation and an amyloid PET scan were successful in allowing Alzheimers to be ruled out as the cause of her problem. Knowing the answer in her case was elsewhere, other possible causes were explored,
A cardiac consultation uncovered Georgie’s circulatory problem, and her later therapy centered on implanting a pacemaker to improve her cardiovascular system.
Based on Georgie’s experience, it had become reasonable fo believe in the possibility that a substantial minority of patients may have PET scans that would be normal if tested. This coupled with adequate neurological consultation might lead a doctor and patient to believe the cause of problems to be elsewhere.
From 2017 through 2021 Dr. Khatib has made philanthropic gifts to study the confirmation of Alzheimer’s disease for those patients that are on the medications Nemenda (and or Aricept) and have not had a confirmation PET scan performed. The Day Medical Center in Stuart Florida and the University of Miami Neurology department in Miami, administered the grants to provide the PET scans for those patients that met study criteria.
“I believe", said Dr. Khatib, “That more patients who have been prescribed Alzheimer’s medication should have the opportunity to receive an Amyloid PET Scan to confirm the diagnosis. If the results are normal, medications should be re-evaluated and would likely be discontiniued, and a work-up to hopefully reveal the real cause of dementia should start."
With the help of such studies, it will hopefully be possible to convince private insurance companies that they need to take a hard look at helping make accurate diagnostic methods more affordable. Fortunately, the Medicare Program’s new policy will make better diagnostic practices a fact.
An Amyloid PET Scan is a specialized type of brain scan that can improve certainty that Alzheimer’s is the cause of a person’s memory loss. These scans utilize a specialized molecular imaging tracer that bonds to amyloid deposits in the brain, often a tell-tale sign of Alzheimer’s disease. Though the presence of amyloid does not guarantee or predict that a patient has or will develop Alzheimer’s disease, a lack of amyloid definitively rules out the Alzheimer’s diagnosis. This opens the door to exploring alternative diagnoses and treatment plans for cognitive impairment.
From 2017 through 2021 Dr. Khatib made philanthropic gifts to study the confirmation of Alzheimer’s disease for those patients that were on the medications Nemenda (and/or Aricept) but have not had a confirmation PET scan with neurological consultation performed.
The Day Medical Center in Stuart Florida and the University of Miami’s Department of Neurology administered the grants to provide the PET scans for those patients that met study criteria.
Findings
In the initial study funded in part through the Khatib Foundation, preliminary results demonstrate that of 103 patients scanned:
- 34 (33%) patients were found to be Amyloid negative and 16 patient’s medications were discontinued after the negative scan.
- 69 (67%) patients were Amyloid positive. Of the 69 patients 54 patients were on meds before the study. After the positive PET result, the number of patients prescribed medications were 57.
The final study will include additional information as to differential diagnosis for the Amyloid negative result study. The University of Miami Neurology department was tasked with submitting the entire study for publication.