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Widespread testing for Alzheimer's not yet valuable

Test of the month

Aug. 7, 2013
 
This undated image provided by Merck & Co., shows a cross section of a normal brain (right) and one of a brain damaged by advanced Alzheimer's disease. / AP file photo
Researcher Sterling Johnson of UW School of Medicine and Public Health

Get involved

Healthy adults with or without parental family history can enroll in the Wisconsin Alzheimer’s Disease Research Center by contacting the ADRC at www.adrc.wisc.edu.
The Alzheimer’s Disease Genetics Study gathers and analyzes genetic and other information from 1,000 or more families in the U.S. with two or more members who have late-onset Alzheimer’s. To learn more about the Alzheimer’s Disease Genetics Study or to volunteer, contact The National Cell Repository for Alzheimer’s Disease toll-free at 1-800-526-2839 or visit www.ncrad.org.
Source: National Institute on Aging

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Will I be next?

Some people with a parent who suffers with Alzheimer’s disease might wonder if their risk of the debilitating disease can be expected because of a genetic link with a first-degree relative.

Some might consider genetic testing so they know their fates, but the Alzheimer’s Association does not recommend genetic testing for the general population. There are so many factors and about 100 genes suspected in the development of the most common form of the brain disease, late-onset Alzheimer’s.

At the present, a family history seems to be about as good a predictor of the development of Alzheimer’s as having the E4, isoform of the gene APOE. It is a risk factor seen in about 40 percent of all people with late-onset Alzheimer’s, but just having it does not predict an individual will ever have the disease.

“Just this year, researchers have mapped the entire genome in people with Alzheimer’s disease,” said Sterling Johnson, a professor and researcher for the Wisconsin Alzheimer’s Disease Research Center within UW Health in Madison and the Madison VA Hospital.

In most people with Alzheimer’s, symptoms, such as memory loss and issues with problem-solving, confusion over time and place, vision/spatial issues and impaired reasoning or judgment, first appear after age 60, according to the National Institute on Aging, or NIA.

The more rare form of Alzheimer’s, early-onset, is the type in which symptoms appear in a person’s 50s or earlier.

Johnson said it’s an exciting time in the field and within the next few years, researchers will know much more about the connections between genetics, medical and lifestyle factors related to Alzheimer’s. For example, Johnson said, genes on chromosome 19 are under study that might one day be useful in predicting the age someone could develop the disease.

“We are making lots of progress,” Johnson said. There are 1,500 people with a family history of the disease involved in the Wisconsin Registry for Alzheimer’s Prevention and 450 participating in the Wisconsin Alzheimer’s Research Center helping to better predict AD.

They participate in cognition exams, brain scans, blood and glucose tests to determine if they are showing signs of Alzheimer’s at an earlier age.

Understanding your family's genetics

Familial Alzheimer’s Disease, or FAD, means there is at least two affected individuals with the disease who are third-degree relatives or closer.

A child whose mother or father carries a genetic mutation for FAD has a 50/50 chance of inheriting that mutation, according to the NIA.

Genetic testing is something to be considered with the understanding that just having a gene or mutation associated with Alzheimer’s disease does not mean a person has the disease.

The process can begin with your family physician who would typically refer patients to a genetic counselor who can explain positive and negative results of the testing.

Dr. Julie Luks, who works as Aspirus Women’s Health medical director, said the blood tests are sent to specialized labs for analysis.

The family member might find out they carry a specific gene mutation but the way that information is put to use and the value of knowing must be shared with a genetic counselor or other expert in the field.

It is unlikely that genetic testing will ever be able to predict the disease with 100 percent accuracy because too many other factors might influence its development and progression, according to the NIA.

“If we had interventions that worked in postponing the onset of Alzheimer’s, the case could be made for more proactive testing,” Johnson said.

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