Estimating and disclosing the risk of developing Alzheimers disease: Challenges, controversies and future directions

Department of Health Behavior & Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
Future Neurology 07/2010; 5(4):501-517. DOI: 10.2217/fnl.10.31
Source: PubMed


With Alzheimer's disease increasing in prevalence and public awareness, more people are becoming interested in learning their chances of developing this condition. Disclosing Alzheimer's disease risk has been discouraged because of the limited predictive value of available tests, lack of prevention and treatment options, and concerns regarding potential psychological and social harms. However, challenges to this status quo include the availability of direct-to-consumer health risk information (e.g., genetic susceptibility tests), as well as a growing literature suggesting that people seeking risk information for Alzheimer's disease through formal education and counseling protocols generally find it useful and do not experience adverse effects. This paper reviews current and potential methods of risk assessment for Alzheimer's disease, discusses the process and impact of disclosing risk to interested patients and consumers, and considers the practical and ethical challenges in this emerging area. Anticipated future directions are addressed.

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    • "Limitations in test sensitivity and specificity coupled with the lack of treatment options for the disorder have prompted concerns about introducing this type of genetic testing for AD into clinical practice (AGSEC 2001; Farrer et al. 1995a; McConnell et al. 1998; NIA et al. 1996; Post et al. 1997). However, predictive testing is already available for families with rare early-onset forms of AD (Lennox et al. 1994) and susceptibility testing, along with predictive testing using neuroimaging results and other biomarkers, may one day become a viable option for the millions of first-degree relatives of patients with AD who are at increased risk for developing this disease (Roberts and Tersegno 2010). There is some evidence that the incidence of AD, the impact of risk factors causing the disease, and the impact of family history may differ between African Americans and Whites (Farrer et al. 1997; Gurland et al. 1999; Tang et al. 1998, 2001). "
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