Posts Tagged ‘test for Alzheimer’s disease’

More Thoughts of Alzheimer’s Disease Testing

Thursday, January 27th, 2011

There has been a great deal of talk in the news recently about Alzheimer’s disease testing for those showing no signs or symptoms of dementia.  In the past, genetic testing for Alzheimer’s disease was available, but the test was notoriously inaccurate.  Now, blood tests can predict with complete accuracy whether or not you will develop Alzheimer’s disease at some point.  It sounds like something we would all need to know, until you look a little deeper at the issue.

Alzheimer’s disease is only one of many forms of dementia.  The technical disease process may be different from one form to another, but if you are the victim or the caregiver, Alzheimer’s disease vs. dementia in most other forms doesn’t look significantly different to you.  Dementia can strike at any age, whether from injury or disease process. If you have negative results for an Alzheimer’s test, it doesn’t mean you won’t get an Alzheimer’s “look-alike” dementia, and if you have a positive test, you may not live long enough to get Alzheimer’s disease. You could have a positive test and die at a ripe old age BEFORE you develop it.

In terms of Alzheimer’s disease, 47% of 85 year olds have it. That doesn’t count other forms of dementia caused by vascular disease, Parkinson’s disease, Lewy Body disease, etc.  To me, it boils down to statistics: If longevity runs in your family and you expect to live past 85, you have a > 50% chance of developing some type of dementia. If your lifestyle or family history would indicate that you could expect to die younger, your chances are decreased all the way down to about 5% at age 65.

Everyone should be prepared to be mentally or physically disabled, in terms of legal documents, insurance, etc., whether from Alzheimer’s disease or anything else. It’s part of living responsibly. Learning via blood test that I have the potential to develop Alzheimer’s at some point doesn’t really add any new information to my world, so I do not recommend paying the money (not covered by most insurances) for the test.  What would it do for me, other than make me worry that I’m getting Alzheimer’s disease every time I can’t remember someone’s name or where I put my car keys?

The value of this test, in my opinion, is for researchers, not lay people.  If researchers can follow groups of people who have tested positive for Alzheimer’s disease, they can learn more about it.  The more knowledge we have concerning this disease, the more likely we’ll be able to find a cure.

Testing for Alzheimer’s Disease: Do you want to know?

Tuesday, January 25th, 2011

The following is an article written by Dementia Dynamics Co-Founder and Medical Director, Daniel C. Potts, M.D., for the American Academy of Neurology’s online caregiver website (http://patients.aan.com/news/?event=read&article_id=9245), for which he is one of the editors.

Alzheimer’s disease has been called the greatest healthcare challenge of this century, with over 5 million Americans currently carrying the diagnosis.  An estimated 10 million of the baby-boomer generation will develop the disease, creating a medical “juggernaut” which may bankrupt our healthcare system as it wreaks havoc on patients, families, communities and care givers.

Those of us who have affected relatives can’t help but be concerned about our risk of developing the disease.  I have worried about this myself…my father died of Alzheimer’s in 2007.  It turns out that laboratory and radiologic tests are now available which may help to determine one’s risk of developing the disease.  Tests analyzing spinal fluid obtained from a lumbar puncture, specialized PET scans of the brain, and genetic testing of blood samples can shed predictive light on risks.  But, given the lack of cure or clearly effective prevention, should these tests be widely utilized?  If obtained, should results be revealed to patients?  Is it ethical for medical professionals to withhold them?

A recent New York Times article addresses this dilemma (Tests Detect Alzheimer’s Risks, but Should Patients Be Told?). Stories of several patients are shared, and experts in neurology are quoted giving their opinions.  It is a thought-provoking and informative piece, but in the end, the quandary remains.

In my practice, I have chosen to not routinely order such testing until effective treatments are available.  If a patient specifically requests it, I try to discuss all the ramifications I can think of, in all honesty hoping to talk them out of it.  Alzheimer’s disease can be diagnosed with great accuracy on clinical and imaging grounds alone without the use of potentially invasive tests.  When proven-effective preventative measures are developed, then I will change my practice.  Until then, in individuals who are without significant symptoms and apart from a research study, I don’t plan to order the testing.  As a neurologist and the son of an Alzheimer’s victim, I don’t want to know my own results.

What do you think?  Do you want to know if you may have the laboratory or genetic markers for Alzheimer’s disease when there is no effective treatment or prevention? Would you want your doctor to know and not tell you?  Tell us your story and share your thoughts.

American Academy of Neurology online caregiver community – one of the editors