• By Soledad Andrade

La enfermedad de Alzheimer generalmente puede identificarse en las primeras etapas

February 3, 2015

ESTIMADA MAYO CLINIC:
¿Cuán pronto se puede diagnosticar la enfermedad de Alzheimer, y cuáles son los primeros síntomas observables?

ilustración de un cerebro sano y otro con la enfermedad de Alzheimer

Izquierda: un cerebro sano con neuronas sanas; derecha: cerebro con la enfermedad de Alzheimer que muestra placas, marañas y neuronas enfermas.

RESPUESTA:
No existe ningún examen que diagnostique la enfermedad de Alzheimer, pero en base a la valoración de los síntomas y a una variedad de pruebas y análisis, generalmente es posible identificarla en las primeras etapas. Apenas se tornan observables los síntomas de la enfermedad de Alzheimer, es fundamental buscar atención médica para establecer pronto el diagnóstico.

El primer síntoma más común de la enfermedad de Alzheimer son los olvidos. Sin embargo, es complicado distinguir entre la pérdida de la memoria debido a la edad y la pérdida de la memoria por la enfermedad de Alzheimer.

A medida que una persona envejece, el cerebro pierde células o neuronas, lo que puede dificultar aprender nuevas cosas o recordar palabras conocidas. Los ancianos pueden, por ejemplo, enfrentar dificultades para recordar el nombre de una persona conocida o tener problemas para encontrar los anteojos de lectura o las llaves del automóvil. Sin embargo, en la mayoría de casos, esas lagunas mentales no son señales del inicio de la enfermedad de Alzheimer.

El tipo de olvido que es preocupante implica olvidar información que uno jamás la habría olvidado antes. Por ejemplo, faltar a un evento social favorito, como un té con amistades o el juego de golf semanal, o no percatarse de algo marcado en la agenda que siempre fue prioritario para la persona, como una cita con el médico. Si eso ocurre de vez en cuando, probablemente no sea un problema; pero si la persona empieza a tener problemas frecuentes para establecer esas conexiones, entonces es momento de acudir al médico.

Una evaluación médica también viene al caso cuando las lagunas mentales ocasionan problemas en la vida cotidiana de la persona, o alguien empieza a tener dificultad para realizar tareas mentales. Ejemplos de esto son sentir agobio o confusión ante la necesidad de tomar una decisión, tener dificultades para conducir, irritarse o fastidiarse cuando se requiere concentración mental, perderse rumbo a un lugar conocido, o tener dificultad para seguir instrucciones detalladas.

Otro ejemplo de una señal de advertencia de la enfermedad de Alzheimer puede ser un cambio en el comportamiento o en la personalidad, tal como que una persona normalmente extrovertida se retraiga de sus amigos y familiares y se rehúse a participar en compromisos sociales. La depresión y otros cambios en el ánimo de la persona pueden también ser síntomas del inicio de la enfermedad de Alzheimer.

Cuando después de revisar los síntomas de la persona el médico sospecha la presencia de la enfermedad de Alzheimer, vale la pena realizar pruebas para evaluar la memoria y otras capacidades del pensamiento, juzgar las capacidades funcionales e identificar cambios en el comportamiento a fin de determinar si éstos pueden atribuirse a la enfermedad de Alzheimer. De igual manera, es útil conversar con los familiares de una persona respecto a sus capacidades cognitivas y funcionales, así como sobre los comportamientos diarios y su cambio con el transcurso del tiempo.

Los exámenes por imágenes y los análisis de laboratorio pueden mostrar lo que ocurre en el cerebro. Las imágenes cerebrales obtenidas mediante tomografía computarizada, resonancia magnética o exploraciones con tomografía por emisión de positrones (PET) pueden mostrar la disminución de las neuronas o el desarrollo de las proteínas que contribuyen a la enfermedad de Alzheimer. Los análisis de laboratorio pueden ayudar a descartar otros trastornos que pueden ocasionar síntomas similares a los de la enfermedad de Alzheimer, tales como un trastorno tiroideo o la deficiencia de vitamina B12. Este tipo de evaluación minuciosa generalmente logra diagnosticar la enfermedad de Alzheimer en las primeras etapas.

Un diagnóstico oportuno y exacto es importante porque una vez que se identifica la enfermedad, los médicos pueden ofrecer medicamentos para controlar los síntomas y posiblemente lentificar el deterioro de la memoria y de otras capacidades cognitivas. Saber que uno padece la enfermedad de Alzheimer cuando todavía se encuentra en las primeras etapas también permite al enfermo y a sus familiares informarse respecto a cómo lidiar con el problema y tener tiempo para hacer planes a futuro.

Dr. Ronald Petersen, Centro para Investigación sobre la Enfermedad de Alzheimer de Mayo Clinic en Rochester, Minnesota

I'm trying to work through the opening paragraph. Does this actually mean that if you meet one of the four criteria but are still working that Mayo considers you a retiree?

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Was not aware of the $5000 life insurance benefit as a retiree. I just assumed that the life insurance benefit terminated once employment was terminated. Thanks.

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So just what are the subsidy amounts I've heard 2 numbers from other people ? One person told me same as last year of $4700.00 (roughly) the second person said it's been cut to $ 1700.00 (roughly)this year ? So if I were to retire this year pre-medicare eligible I would be able to use the subsidy for my coverage from Mayo or the marketplace ? (Quote from above) Mayo reserves the right to transition pre-Medicare retirees to the Health Insurance Marketplace in the future, as communicated in September 2015. So with this statement from above if Mayo bounces me to the marketplace coverage would Mayo still charge me cobra prices minus the subsidy ? Or would they be reduced to comparable prices on the marketplace ? Or does Mayo just drop me and I find my own coverage on the marketplace using the subsidies ? Thank you Ray

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Why isn't the LaCrosse campus a site where subsidy is offered at retirement? I thought one of the FUSION goals was to have benefits be equal across the system

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Does one still qualify for the subsidy benefit if they have exactly 10 years when they retire from Mayo at age 70 and have been on Medicare and have Blue Cross Blue Shield or TriCare (from military retirement)as their supplemental policy?

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Can you confirm if I am understanding this correctly using my personal situation? I am Eligible for the Subsidy, am single, and age appropriate to retire (over 55, with 25+ years with Mayo), and would like to maintain my existing Mayo Premier coverage. If I retire say in 2016, Mayo would subsidize around $4,700 for me to be used and I could choose to stay with Mayo premier. For this option, I think you gave a cost of $510/month or $6,120 per year. So, my cost other than the existing Premier deductibles, or out of pocket, would be the difference from the $6,120 Premier cost, and the $4,700 or around $1420? So I should budget at least $3,500 to meet the maximum out of pocket for Premier of $2,000 for single person and the difference between the subsidy and the plan cost of $1420? Of course this is until required to purchase from the market plans, where hopefully a Mayo plan is an option, or until I reach Medicare eligible age. In addition for budgeting purposes, since the subsidy will not increase could you give a conservative average of how much that Mayo insurance has risen historically each year. Think it prudent I add in the annual medical increase as the subsidy will remain static. Also, can you speak to ramifications and cost differences if pre-Medicare, subsidy eligible, single and retiring between taking the 18 months Cobra or taking the Mayo Subsidy and Premier? Does Cobra force you to the market place, or can you stay with your existing Mayo plan, in my case Premier and if so what is my cost share with Cobra? And after Cobra are there any restrictions with my returning to the Premier option. Recognizing, that this is until forced to the market place for a healthcare choice, with Mayo being hopefully one of our choices.

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Does the years of service start at any age you were full time here at mayo? Say someone starts full time at the age of 18, does the continuous years start there or when the person was 21? Or does the age not matter?

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I work in La crosse…Started in 2000 If I was to take a job in Rochester for the 2 next before I retire, would I be eligible for the subsidy?…Thanks Rick

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What is the Cobra price for benefits if you do not qualify as a retiree?

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For medical coverage after retirement. With both spouses working at Mayo and one spouse retires and is Medicare eligible can the working spouse cover the retired spouse under family coverage instead of an outside Medicare supplemental insurance policy? If so doe the Mayo family policy become a secondary payer?

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Tim – Great question. If you read the headers of the chart, you will notice both require "termination" of employment. Thanks, Your Benefits Team

** Comment posted by subject matter expert **

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@raymondphelps

So just what are the subsidy amounts I've heard 2 numbers from other people ? One person told me same as last year of $4700.00 (roughly) the second person said it's been cut to $ 1700.00 (roughly)this year ? So if I were to retire this year pre-medicare eligible I would be able to use the subsidy for my coverage from Mayo or the marketplace ? (Quote from above) Mayo reserves the right to transition pre-Medicare retirees to the Health Insurance Marketplace in the future, as communicated in September 2015. So with this statement from above if Mayo bounces me to the marketplace coverage would Mayo still charge me cobra prices minus the subsidy ? Or would they be reduced to comparable prices on the marketplace ? Or does Mayo just drop me and I find my own coverage on the marketplace using the subsidies ? Thank you Ray

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The pre-Medicare subsidized family premium for Premier is $748/month and Select is $510/month. The HRA contribution (if subsidy-eligible) for a Medicare-eligible individual is $1,764/year for a single, and $3,528/year for a married couple. This is the same amount as was announced in 2014. What changed is that rather than send pre-Medicare individuals to the public marketplace, Mayo decided to delay that transition for the foreseeable future and allow individuals to remain in the Mayo Medical Plan until Medicare-eligible. So there is a subsidized benefit for those who qualify and retire prior to age 65. More information is available by searching “retiree medical” in For You. Thank you, Your Benefits Team

** Comment posted by subject matter expert **

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@ldc04

Why isn't the LaCrosse campus a site where subsidy is offered at retirement? I thought one of the FUSION goals was to have benefits be equal across the system

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Subsidy offerings were discontinued as of 1/1/02, so any new hires at any site after 12/31/01 are not eligible to receive a subsidy. The choice to offer or not offer a retiree subsidy was made at each Mayo Clinic Health System location by leadership when they became a part of Mayo Clinic; therefore, employees hired prior to 1/1/02 at the sites not specifically included in the article above are not eligible to receive a subsidy. Thank you, Your Benefits Team

** Comment posted by subject matter expert **

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@danielhuff

Does one still qualify for the subsidy benefit if they have exactly 10 years when they retire from Mayo at age 70 and have been on Medicare and have Blue Cross Blue Shield or TriCare (from military retirement)as their supplemental policy?

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Daniel, one of the requirements to be eligible for the subsidy is to be continuously benefits eligible since 12/31/01, so the math does not work. Anyone with exactly 10 years of continuous service today could not have been hired on or before 12/31/01. Thank you, Your Benefits Team

** Comment posted by subject matter expert **

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@christaeastvold

Does the years of service start at any age you were full time here at mayo? Say someone starts full time at the age of 18, does the continuous years start there or when the person was 21? Or does the age not matter?

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Here is the definition of continuous service from the summary plan description: "Period of unbroken service from hire date to termination date with the Employer or an affiliated company by an employee who is classified as a regular employee and is scheduled to work at least half-time (.5 FTE). Vacations and approved leaves of absence are not breaks in service except for educational leaves of more than 6 months for a non-critical employment need. Transfers between the Employer and affiliated companies are not breaks in service as long as the employee continues to be classified as a regular employee and continues to be scheduled to work at least half-time. A break in service occurs upon termination of employment, upon transfer to a non-regular classification or upon change to a schedule that is less than half-time. A regular employee classification does not include temporary, supplemental or casual employees or residents, research fellows or health-related science students." Thank you, Your Benefits Team

** Comment posted by subject matter expert **

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