5-in-1 Dementia Test Rules Out Alzheimer's

Monday, 18 Mar 2013 08:05 AM

 

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As Baby Boomers age, those everyday questions of life -- Where are the car keys? What was her name again? -- are increasingly followed by another: Can this be Alzheimer’s disease?
 
Monday, Quest Diagnostics Inc. (DGX), in the midst of a company reorganization that seeks to cut costs and boost revenue with improved service, will introduce a panel of tests at the American Academy of Neurology meeting that combines five screens into one to pinpoint potentially treatable conditions.
 
The concept is that, by simplifying the process and making it more accessible, an increasing number of family doctors will use the test and, in some rare cases, ease the mind of patients by ruling out Alzheimer’s.

ALERT: These 7 Things Activate Alzheimer’s In Your Brain
 
“It’s sort of a simple idea, but dementia is a common presentation to primary-care doctors,” said Joseph Higgins, medical director for Quest’s neurology unit, in a telephone interview. “Sometimes they’re at a loss for what type of blood test to perform. This panel puts them all together in one place, with one report.”
 
Quest, the biggest U.S. operator of medical labs, could use a boost. Its sales have come under pressure as hospitals have sought fewer tests and reimbursement has become more stringent, said Frank Morgan, an analyst with RBC Capital Markets.
 
Quest’s stock has dropped 6.2 percent in the past 12 months, compared with a gain of 21 percent for the Standard & Poor’s 500 Health Care Index. Quest declined less than 1 percent to $56.22 at the close on March 15.
 
Swelling Numbers
More than 5 million people in the U.S. have Alzheimer’s, an incurable, mind-robbing disease that worsens over time, according to the Alzheimer’s Association. It’s estimated that may swell by 10 million as Baby Boomers enter old age.
 
Yet, while rare, there are other causes of memory and focus loss that are reversible, including low levels of vitamin B12, thyroid problems, and undiagnosed metabolic disorders, according to Madison, New Jersey-based Quest.
 
“The number of times a doctor will see an Alzheimer’s patient is going to go up,” Higgins said. “Primary-care doctors are going to be the ones usually doing the first screening. This makes it convenient.”

The test suite is based on guidelines recommended by the American Academy of Neurology and the American Academy of Family Physicians. It includes a complete blood count, a comprehensive metabolic panel and tests for levels of vitamin B12, thyroid-stimulating hormones, and folate, Higgins said.
 
Revenue Decline
The company’s push into neurology testing comes as Quest’s revenue has declined 1 percent since 2009, to $7.38 billion last year, and is expected to be unchanged in 2013, according to the average of 22 analysts’ estimates compiled by Bloomberg. Of 24 analysts covering the company, just two recommend buying. Twenty have a hold rating while two say sell.
 
“They’re looking to reduce their cost structure and at the same time looking at ways to grow their top-line longer term,”RBC’s Morgan, who has a sector perform rating on the shares, said in a telephone interview. “A lot of focus has been spent on retooling the internal culture of the company and being more customer-focused.”
 
Quest offers blood and genetic testing for everything from allergies to women’s health.
Competitor Laboratory Corp. of America Holdings, based in Burlington, North Carolina, has faced similar pressures, said Sandy Draper, an analyst with Raymond James in Atlanta with a sell recommendation for both stocks.

ALERT: These 7 Things Activate Alzheimer’s In Your Brain
 
Neurology Expansion
Quest expanded into neurology testing in 2011 with its $740 million purchase of Athena Diagnostics from Thermo Fisher Scientific Inc. The tests included in the new panel are available individually as well, and the $330 cost of the sum of them is the same as the full suite, said Stephen Becker, executive director of Quest’s neurology segment. The company expects insurers to reimburse patients for some of the cost.
 
Quest’s testing panel may not turn up a huge number of treatable cases of dementia. Reversible forms are much less common than Alzheimer’s disease and others such as vascular dementia, said David Knopman, a member of the American Academy of Neurology and a professor of neurology at the Mayo Clinic in Rochester, Minnesota.
 
“Unfortunately and disappointingly, it is exceedingly rare” to find cases of treatable dementia, he said in a telephone interview. Knopman was part of the group that wrote practice guidelines in 2001 for screening tests.

 
Still, Quest aims to be an important part of ruling out those possibilities before family practitioners refer patients to neurology specialists, and also for neurologists themselves, Higgins said.
 
‘More Aware’
Charles Cutler, a general internist in Norristown,Pennsylvania, near Philadelphia, said he uses the individual tests now, and the number of positive results are low.
 
The number of patients Cutler’s seeing who come in worried about Alzheimer’s, though, is on the rise, he said.
 
“We are more aware of dementia than we were 10 years ago,” Cutler said in a telephone interview. “In the trenches, where I am, the conversations are coming up much more frequently. The interesting thing is patients who don’t even have dementia begin to worry about it.”

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