Is Alzheimers in your Future?
Due to a great leap in technology, many tests for Alzheimer’s and Dementia are available now that were not available only a few years ago. This leaves many physicians in a quandary. When the ability is there to predict a future disease but no available treatment on the horizon–should they tell the patient their test results anyway?
Certainly, there are differing opinions on the subject. Some doctors, like Dr. John C. Morris of Washington University in St. Louis, say they will not offer the new diagnostic tests for Alzheimer’s — like M.R.I.’s and spinal taps — to patients because it is not yet clear how to interpret them. He uses them in research studies but does not tell subjects the results.
Dr. Rafii knows about the new tests and how to use them because he is an investigator in the study of memory disorders clinic at the University of California, San Diego. Dr. Rafii sometimes offers the study’s diagnostic tests: spinal taps and M.R.I.’s to look for shrinkage in important areas of the brain; and generally tells the patient of his findings. Other doctors differ in how far they will go with the information they find.
Dr. Mony J. de Leon of New York University, for example, takes a middle ground. He is studying people at increased risk for Alzheimer’s or other dementias, especially those whose mothers had Alzheimer’s. That sort of family history, he has found, makes the disease more likely.
Dr. de Leon provides people with a sort of general assessment, telling them they are at increased risk, decreased risk or somewhere in the middle, however, he says, “We do not reveal their scores.”
It is not only a dilemma when dealing with Alzheimer’s. Technology has produced many new diagnostic tools, from scanners to genetic tests, that can find diseases or predict disease risk decades before people would notice any symptoms. Yet, not all these diseases have cures or even treatments available at this time.
“This is the price we pay” for the new knowledge, said Dr. Jonathan D. Moreno, a professor of medical ethics and the history and sociology of science at the University of Pennsylvania. There is so much more information available now, yet the doctor must decide how much he will actual tell the patient.
And, how much would the patient want to know if there was no treatment available. Many people want to know anyway. At least they think they want to know. One doctor suggested that telling Alzheimer’s results when the patient will not be affected until some point in the long distant future is “psychologically invasive.”
But for neurologists like Dr. de Leon, the future is fast approaching, as patients increasingly demand to know. “The floodgate is about to open,” Dr. de Leon said.
For myself, I feel fairly certain it will be in my future. My mother and grandmother both had Alzheimer’s, so why wouldn’t I? But to have a test and definitive answer. No, I don’t want that right now.
What do you think? Would you want to know?