He’s one of the most well-known Alzheimer’s patients in history, and now his speeches may help doctors identify early signs of the disease.
In a new study, researchers analyzed former president Ronald Reagan’s speaking patterns during his two terms in office, and found early indicators of dementia in his speeches prior to his Alzheimer’s diagnosis in 1994.
It's hoped that the findings could provide doctors with a way to detect the disease earlier. It's a goal researchers have been trying to reach for years, says Richard Lipton, MD, director of the Division of Cognitive Aging and Dementia at Montefiore Medical Center, who wasn't involved in the study.
Using transcripts of the 46 news conferences Reagan held while president, Arizona State University researchers Visar Berisha, PhD, and Julie Liss, PhD searched for early signs of dementia, including the use of repetitive words, swapping out specific nouns for non-specific words such as “thing,” and a decline in the use of complex words.
They also compared Reagan’s speech to that of former president George H. W. Bush, using 101 sessions Bush held during his four years in office. They found no signs of dementia in Bush’s word use over time, according to the study, which was published in The Journal of Alzheimer’s Disease.
Berisha told the New York Times that he didn’t initially intend to focus on Reagan for the study, but he was the only public figure with progressive dementia who gave a large number of speeches over a span of time. Similarly, Berisha compared Reagan to Bush because of the availability of his speeches and because they were similar in age and of the same generation--factors that can affect speech patterns.
Dr. Lipton says the research is part of a trend towards trying to pick up Alzheimer’s long before symptoms become severe. “The new paradigm is the recognition of Alzheimer’s disease many, many years before the Alzheimer’s dementia sets in, so that doctors have the ability to intervene and prevent the dementia from occurring.”
Even when symptoms are severe, it can be hard to diagnose Alzheimer's disease. Doctors use a process of elimination, along with CAT scans and spinal taps, to rule out other conditions. If a patient shows signs of what seems to be dementia, Alzheimer’s is a common cause, but it could be due to other issues, such as depression or a shortage of vitamin B12.
“The diagnostic tests are not designed to show signs of Alzheimer’s, but to eliminate other diseases,” Dr. Lipton says. While it would be ideal to find a simple blood test, that hasn't happened.
Catching Alzheimer’s as early as possible is the overall goal for doctors, in the hopes that they can help slow down or halt the process. Although there are FDA-approved medications for Alzheimer's patients, they can't stop the disease.
“What everyone wants is a medicine that not just boosts cognitive function on a short-term basis, but also changes that slope and slows the rate of decline enough that people never develop dementia,” Dr. Lipton says. “Thus far that’s just a pipe dream, but a pipe dream that many people are spending their lives researching.”
The researchers are looking into recording conversations between doctors and patients to see if changes in speech patterns can pick up the disease earlier.
When it comes to putting Berisha’s research into practice, Dr. Lipton is positive, but wary.
“Bush talked about a thousand points of light, and I’m happy to say that in Alzheimer’s researcher there are also a thousand points of light, and we don’t know which of those will become mainstays of medicine in the future and which of those will be replaced by things that are better,” he says.
“I view this kind of language assessment as one kind of light, and I don’t know if it becomes a mainstay or something that passes. But I’m glad for the thousand points of light.”