Alzheimer’s: Would You Want to Know Your Risk?

Alzheimer’s disease is the downside—and looming threat—of rapidly improving longevity. Not surprisingly, aging is the single greatest risk factor for developing the disease. For the 65 and older population of the United States, the odds of having Alzheimer’s are 1 in 6.86. For those 85 and older in the US, the odds jump to 1 in 1.57 (63.7%). There is not yet a cure, and the drugs currently prescribed seem to only slow the disease for a year at most, and only in about half of patients who take them. Though aging is one factor that can’t be changed (without moving to Neverland), it may eventually be possible to lower other Alzheimer’s risk factors.

Alzheimer’s disease appears to have many causes—genetic, environmental, and otherwise—and most of these are still unknown. But many studies have pinpointed one form of a gene known as APOE as a potential Alzheimer’s risk factor, and genetic tests exist to show whether a person carries zero, one, or two copies of the potentially harmful APOE-e4 form. The presence of APOE-e4 does not guarantee that a person will have Alzheimer’s; likewise, the lack of APOE-e4 does not guarantee that one will not get the disease. It merely indicates an increased risk.

Due to the progressive and incurable nature of the disease, most researchers have long assumed that if people were able to be tested for genetic risk factors for the disease, they would suffer negative psychological effects upon finding out that they had the risk factors. However, a study by researchers at Boston University School of Medicine published in The New England Journal of Medicine in July 2009 suggests that this may not be the case. 162 subjects volunteered to receive APOE-e4 testing, and 2/3 of the group was given results while the rest received information about risk factors. Researchers followed test subjects for a year and determined that no significant psychological problems occurred, even in the subjects who learned that they did have one or two copies of APOE-e4. Furthermore, 98% of those subjects who received genetic test results said that they were glad they had taken the test, regardless of the results they received.

Psychological effects aside, some see other risks involved in genetic testing for Alzheimer’s. Privacy is a concern, especially in terms of keeping information away from insurance companies that might not want to pay for the long-term care of someone who has a high risk of developing Alzheimer’s a few years down the road. According to the American Geriatrics Society, federal laws should be in place to prevent discrimination against people who test positive for genetic risk factors for diseases like Alzheimer’s.

Despite the risks, some patients choose to take the test, especially those with immediate family members with Alzheimer’s. Early diagnosis of Alzheimer’s, and thus early treatment, seems to slightly slow the progression of the disease. Even if the visible results are modest, early diagnosis buys a patient and his or her family more time to set affairs in order and face the difficult questions of long-term care.

Leave a Comment