Genetic Risk for AD: Important Information to Embrace

Contributed by: Dennis Fortier, President, Medical Care Corporation

The Washington Post has a health related blog (The Checkup) that often presents interesting viewpoints on a variety of topics. I like reading it and generally find the information useful. Today was not one of those days.

In today's post, the authors argue that it may be better not to know if one is genetically predisposed to higher risk for Alzheimer's disease. As regular readers of this blog already know, that represents a poor understanding of the facts and a position that, for most people, is not in the best interest of health.

Below is the body of the comment I left at "The Checkup".

At the risk of offending the author, it should be noted that "not wanting to know if one is genetically predisposed to Alzheimer's disease" is not a very defensible position once inspected under an educated light.

First, having certain genetic variants (APOe4 or TOM40) may increase risk of one day developing Alzheimer's disease while having a certain others (CTEP) may decrease it. However, no combination of these genes approaches a certainty of fate, they merely suggest probabilities. To imply that learning a bit about one's genetics is akin to knowing the future is to overstate our current understanding of genetics and Alzheimer's disease.

Second, like the author suggested with regards to breast cancer, there is plenty one can do to reduce risks for Alzheimer's (more so than one can do to reduce the risks for breast cancer). For example, there is solid scientific evidence that we should all maintaining good cardio-vascular health (lower LDL's, obesity and BP), enjoy a brain healthy diet (green leafy vegetables, berries, fish with Omega-3's, and fewer fats), remain intellectually and physically active, and stay socially engaged. A few other well supported life-style decisions would be to protect the head against the potential of injury and to stop smoking and excessive drinking. All good advice but perhaps more compelling if one knows they have a high genetic risk for a dementing disorder such as Alzheimer's.

Third, because early stage Alzheimer's has symptoms that look exactly like normal, age-related cognitive decline, it often goes undiagnosed and untreated during its earliest and most treatable stages. If one knows there is an increased genetic risk for the disease, it is more likely that early symptoms will be more vigilantly investigated and medical intervention might occur in a more timely and efficacious manner.

Finally, as other commenters have noted, the problem should be considered in a context broad enough to include more than just the patient. Many other lives are often affected and proper planning can be beneficial to all. The problem of Alzheimer's disease is greatly exacerbated by late detection; a phenomenon that is perpetrated by the antiquated "better not to know" dogma. That may have been true 20 years ago but we need to embrace a higher level of understanding. Journalists who continue to promote that idea are on the wrong side of the solution.

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