Would You Take One of the New Alzheimer's Tests?
Last updated:March 19, 2009
If someone in your family has Alzheimer's (or any dementia), you have a front-row seat on what its peculiar devastation can be like. So how badly do you want to know about your own risk?
The question is still mainly rhetorical. There's currently no "test" that definitively predicts whether you'll get the disease. Memory screenings (such as those doctors conduct in the office) can flag whether you should have a more detailed evaluation but can't diagnose. Genetic testing can reveal if you've inherited the recipe of APOe lipoprotein variants known to be linked to Alzheimer's, found in about half of all those who develop adult-onset disease, but can't predict what will happen to you.
But this week has brought news of some potential new diagnostic tests. University of Pennsylvania researchers say they have validated and standardized a test that can predict with 87 percent accuracy whether mild cognitive impairment will progress to Alzheimer's. It's said to also be able to confirm or rule out suspected Alzheimer's. The breakthrough test measures concentrations in the cerebrospinal fluid of amyloid beta 42 peptide and tau protein, chemical biomarkers for the disease. (The test isn't yet available, pending further testing.)
Elsewhere, in the medical journal Neurology, Dutch researchers say that certain patterns of brain shrinkage seen on MRI scans can foreshadow the development of Alzheimer's. People with a small hippocampus (an area of the brain that helps store memories) that's also shrinking at a high rate had odds of developing Alzheimer's 61-fold higher than those with a larger hippocampus and low shrinkage rate.
So would you line up to take such a test or MRI if they became widely available? At what price? And toward what end?
I know people who are itching to know and would gladly undergo any procedure to have the answer. And I know those who are scared witless by the possibility of having such a vision of their future spelled out. I suppose I fall in the ignorance-is-bliss category. I'd rather go gangbusters on preventative efforts and not dwell on a condition I can't further control. On the other hand, were I to begin showing symptoms of memory loss, I suppose a definitive test would be no different than getting a clear diagnosis of any other disease, and would help me "“ and especially my loved ones "“ make plans.
Helpless though we are now to know our brain fates, pondering the question reminds us that there are a few specific actions a concerned caregiver can take right now:
Learn the risk factors for Alzheimer's and lower as many as you can control. Bear in mind the ongoing research, which intensified last week, casting Alzheimer's as a possible form of diabetes.
Get your own ducks in a row. Peeved that your parents refused to make an eldercare plan? Do something. Do what you can to avoid putting your kids in the same situation. At the very least clarify a medical power of attorney and think through some possible scenarios for your future care.
Pay attention to your body "“ but don't panic. If you're genuinely concerned about your memory now, see a doctor. Know that stress, medications, head injury, illnesses such as urinary tract infection, and a host of other treatable conditions "“ not just Alzheimer's disease -- can interfere with cognitive ability. But also remember that currently caring for someone with dementia makes you hypersensitive to the condition. Learn the difference between normal memory loss and dementia.
And meanwhile give some thought to whether you'd jump at the chance to know your cognitive future, should technology one day soon make this possible -- or not.
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