This Alzheimer's blood test, PrecivityAD2, is based on the p-tau217 biomarker.
In one recent study, people very high p-tau217 had a 38% chance of progressing to cognitive impairment within 5 years vs 12% for those with low levels. The current tests cost about $200-300, so they're not unreasonable as a screening test. PrecivityAD2 looks to be priced around $1,400-$1,500 so at that price, this specific test likely only makes sense for people with established disease.
That sounds pretty expensive for me for a test with that low accuracy, especially when there's not much you can do different if it comes back high vs. coming back low.
Agreed that we can't do as much as we'd like. There are some general health things that are believed to prevent cognitive decline, such as managing cholesterol, HbA1c, blood pressure, sleep apnea, etc. One phrase I've heard is that cholesterol at age 50 predicts cognitive health at age 70.
But hopefully we'll start to have more options and wider approvals for things like anti-amyloid drugs.
That's the viewpoint of everyone sensible outside of Alzheimer's research.
Those in it are still throwing billions per year at the idea.
Meanwhile, back in reality, no amyloid-beta drug has had any clinical effect in humans, other than reducing the plaques. But both the shingles and RSV vaccines are proven to reduce Alzheimer's risk.
Which did not stop the FDA from approving a useless anti-amyloid drug, leading to the resignation of several experts, one of whom called it "probably the worst drug approval decision in recent U.S. history" in his resignation letter. [0]
The "standard" theory is that amyloid leads to tau protein accumulation which leads to neurodegeneration: https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h.... Which would explain why current treatments don't really work: by the time Alzheimer's has progressed to noticeable impairment there's already too much tau, so reducing amyloid will at best slow the rate of decline by reducing the formation of new tau.
> Which would explain why current treatments don't really work ... [they] at best slow the rate of decline
This is called working! I am struck by the double-standard applied to assessing treatment options for Alzheimer's vs cancers. Many (most?) Stage IV cancers are incurable, and the main goal of treatment is to slow progression of the disease. Adding years to patients' lives is absolutely worth it, assuming the side effects are not overwhelming and the costs are not prohibitive.
To wit: Moderna added ~30B to its market cap on the news that it observed _statistically significant_ improvement in its primary endpoint for treating metastatic melanoma. Great! I'm as excited about this development as anyone. A new treatment option for a terrible disease that meaningfully improves on the current standard of care (Keytruda). Sadly, Stage IV melanoma is still considered terminal, and no one suggested that Moderna changed that.
Why not reset expectations for Alzheimer's? If we manage to slow its development enough so that most patients (who tend to be elderly) would die of other causes while maintaining decent quality of life, that's a win in my book.
Hi there. Actually, Leqembi is a 1st gen Alzheimer’s drugs and targets amyloid plaques. But, like other responses, amyloids doesn’t seem to be hugely responsible for Alzheimers, which is why targeting things like tau proteins is being explored.
> Early detection of Alzheimer’s disease is important since the first treatments capable of slowing the progression of the neurodegenerative disease recently became available to patients, and these drugs are more effective when started sooner rather than later. Other promising investigational drugs are in the pipeline.
A very good friend's wife had Alzheimer's caught early, and the medication she's on stopped its progression. It's much better for her than my family members who had no treatment options.
It's going to be replicated because we already know the mechanism of action. That said, many/most people would probably be better off solving the problem more upstream via whatever B-complex vitamins they need based on their bloodwork and DNA methylation variants.
I am not personally aware of any treatment for which there is particularly compelling evidence that it meaningfully slows progression even when started early. I wish there was.
It’s also not clear that one can measure progression well enough that an n=1 data point is meaningful. And I’m also far from convinced that very early Alzheimer’s that would progress rapidly enough to be noticeable can be detected with enough specificity to rule out fairly common cases of people who test positive but effectively don’t have the disease.
Agreed that that it’s an interesting question on how to detect Alzheimer’s and also how to treat. My Dad is starting to show signs of mild mental impairment (he’s 87) - more forgetful than usual, more confused than usual, not able to work his computer like he used to…
He has taken a personal interest in preventing dementia and wants to take the first generation Alzheimer’s drugs, specifically leqembi that works on amyloid plaques. And this is definitely a tough choice, because eventhough it does show some slowing of the disease, it has lot of side effects that may not be worth it.
Personally, I am against it and don’t think it’s worth it as he could do permanent damage to himself. Think he should hang on until the second generation of drugs come out, which should be in the next 1-3 years (there a lot of Alz drugs in the pipeline, but you never know of course if anything will pan out). It’s a tough choice and don’t know if there is a good option at this point.
I'm sorry your dad is facing this disease. Hopefully he can find something that helps slow it. I don't know what the side-effects are that he could be facing but, as someone who lost a parent to alzheimers, let me say that anything is probably preferable to advanced-stage dementia. I hope to see real, reliable treatments in my lifetime.
Thanks for the info on this. Hmmm, maybe Leqembi isn’t such a bad option.
And, would be very surprised if none of the drugs in clinical trials panned out in the next five or six year. It seems like they’re on the verge of making a major breakthrough. Here’s hoping:)
The amyloid treatments slow cognitive decline by 35% or so for 18 months. Some papers argue (and I believe) the effect is small enough many patients don't notice or seem to benefit.
We shall see if yet another generation of amyloid-targeted treatment does any better. The amyloid-hypothesis boosters seem to think so - we had a thread about this not that long ago. But I remain skeptical.
There is an oral PCSK9 treatment (enlicitide) was recently released that provides a 30% reduction, and of course you can't get insurance coverage without the test. And there are 2 drugs with 90%+ reduction in Lp(a) in phase3 trials with expected release in 2027-8, in particular Olpasiran.
We can also test for PSEN1, which is 100% accurate in determining early onset alzheimer's disease, quite a it more expensive, so unreasonable as a screening tool unfortunately.
I am skeptical of 100% anything, so did some looking:
>>Mutations in PSEN1 and APP are associated with complete penetrance, meaning that all individuals who have a PSEN1 or APP mutation will develop AD if they live a normal lifespan [1]
and
>>[Age-of-onset] Usually 40s or early 50s (range 30s-early 60s) [2]
Note that this is only for early-onset Alzheimer's, representing ~5% of all Alzheimer's.
>>Our study showed that the rate of EOAD in AD is 5.5%, not 1-2% as usually demonstrated. And our results indicated that the rate in developed countries was relative higher than in developing countries [3]
I work directly in this field (clinically validated digital cognitive tests that characterize cognition, often paired with p-tau blood tests.) Ask me anything, I guess!
I see results like the OP as speeding up progress. Tests like ptau make it faster and cheaper to screen for participants in clinical trials. This allows more resources to be spent on pre-screening, to identify candidates that might be healthy at time of trial start, but who are likely to develop cognitive impairment during the trial, which can be helpful for better measuring efficacy etc.
There was a good, accessible guidelines paper in the Lancet that described helpful interventions at all stages of life to decrease the odds of developing cognitive impairment later in life.[0]
In terms of late-stage treatments to halt or reverse progression, that still seems very far away. The causes are so diverse... My father died of vascular dementia not too long ago, so I'm familiar with the caregiver side in addition to the business.
I think you need FDA clearance to be able to market a test as actually being effective for treatment/prevention etc. For exactly the same reason woo-woo supplements must disclaim that they aren't intended for that purpose
Because tests aren't completely innocuous? Because tests lead people to make significant medical decisions?
Look at the supplements world, where grifters are shilling chemicals that cause harm and make radical claims for absurd markups. Or gas station pills. You want those companies making Alzheimer's tests? People going in to a 7-11 and buying a "all illness test card" that tells people they do or don't have degenerative diseases?
No, it's very very important to ensure tests are actually indicative and ensure they are well made. To do that, a regulating body needs to be involved.
Their doctor should be qualified to make that judgment without a government bureaucracy evaluating the efficacy of the test on their behalf, unless you want to completely destroy the rate of medical breakthroughs. If there's no potential harm from the procedure itself, the government shouldn't be involved at all.
Imagine if every new AI model had to be "cleared" by a government regulator. The role of government in healthcare evaluation needs to be simplified and streamlined. The liability needs to be shifted to doctor, and if it's a case of charlatanism, that liability should include a lengthy prison sentence.
So we should just let companies flood doctors with potential treatments and then hope they have enough time to figure out whats relevant for their patients?
Seems much better use of time and money to have people developing tests meet a pre-defined standard and after that point they're allowed to flood doctors with marketing for the tests.
What use is future medical advancements if it can't meet low bars like proving it works?
The problem is the FDA's pathetic throughput times. It takes them decades to approve drugs. Blood tests take 1-2 years on average. It's a huge bottleneck. If they could turn these things around faster and work iteratively, it would be different.
Definitely longer than I'd expect for "cleared" considering everybody involved should have to be licensed and pretty sure you pay a fee to the FDA so that should cover the cost of FDA hiring employees to just call each person involved to verify the submission is accurate.
Although IIUC, they were already allowed to do 50yr+ people and the recent clearance is just for 40yr+ so I'm not actually sure how uh impactful this is (a bit more confused why it takes 10 months to drop the age by 10 years).
Some doctors absolutely would abuse this. I used to date someone whose sister was an endodontist and there was another endodontist in the building who was making over $1m a year. She ended up seeing one of that endodontist’s patients and realized that the other doctor had been making all that money by giving people medical procedures they absolutely did not need.
But only another medical professional would know that; the patients were completely oblivious. I said she should blow the whistle but she “didn’t want to rock the boat”. It definitely changed how I feel about doctors. There’s a massive level of trust there, which most doctors will honor but a few will exploit.
Citation very much needed. Society today is full of people in power who exploit others. Cops, ceos, spouses, etc. Very rarely are they "made an example of", and when they are it doesn't seem to change the intuitions.
These tests are more or less useless because there's no treatment anyway so knowing about it a long time in advance will not lead to any substantial gain. Even slowing the disease isn't within the realm of today's technology. Today's pharmaceutical companies are close to quacks as far as Alzheimer is concerned. We know next to nothing about its origins or even how the disease progresses.
The only thing you gain is giving people more time to worry and despair.
Earlier diagnosis, or at least suspected diagnosis, could make a difference in studying progression, origin, etc.
Imagine the test is 100% accurate: if you gave it to a group of people, you could then try to make interventions earlier, capture more data about lifestyle before symptoms, etc.
Patients becoming involuntary guinea-pigs for science? No thanks.
As long as there isn't a clear root cause found and some real mitigating medicines reach the market I would propose keeping people ignorant as long as we can.
Entering a study for people who tested positively would also be voluntary.
Anecdotal responses in this topic indicate there may be some mitigatimg medicines.
Demanding a root cause before doing anything is silly. Finding root cause in biological systems is incredibly difficult; there's value in finding symptoms and managing symptoms without finding a root cause. And dangers of focusing too much on any one indicator.
That's not to say I suggest everyone be screened for everything. If there are limited mitigations, it's not appropriate for most people to be screened. But even if there are no medical mitigations, you might put your affairs in order with appropriate urgency if you knew your cognition would be much reduced in the next 5-10 years.
Who said involuntary? I'd imagine many people, if told they were likely to develop Alzheimers, would be eager to participate in lifestyle interventions or even trials for a potential treatment.
This is an infuriatingly clueless comment. It gives nothing? It allows people to set their affairs in order, and that is an invaluable thing.
Alzheimers can lead to all kinds of other issues like impulsivity, or aggressiveness. People gambling away their life savings, not knowing that they are even doing it. Doctors unable to intervene due to rights around patient autonomy. All of this has big consequences in the lives of those affected.
These tests are not useless, but I’d agree (from personal experience) that it’s far from clear that everyone should take one.
There’s a degenerative genetic disease that runs in my family that for various reasons we only found out about ten years ago. To get the test done in the UK for it, you have to go to mandatory genetic counselling where they try to convince you not to get it done. Of four siblings, the two of us who thought initially we’d definitely get it done, we’ve not, and the two who were sure they wouldn’t, have done.
They try and convince you not to get it done so you don’t end up confusing being tired one morning or tripping with “oh my God it’s starting”.
Everyone should get their affairs in order, regularly, without needing a test, if they care about their loved ones.
This Alzheimer's blood test, PrecivityAD2, is based on the p-tau217 biomarker.
In one recent study, people very high p-tau217 had a 38% chance of progressing to cognitive impairment within 5 years vs 12% for those with low levels. The current tests cost about $200-300, so they're not unreasonable as a screening test. PrecivityAD2 looks to be priced around $1,400-$1,500 so at that price, this specific test likely only makes sense for people with established disease.
That sounds pretty expensive for me for a test with that low accuracy, especially when there's not much you can do different if it comes back high vs. coming back low.
Agreed that we can't do as much as we'd like. There are some general health things that are believed to prevent cognitive decline, such as managing cholesterol, HbA1c, blood pressure, sleep apnea, etc. One phrase I've heard is that cholesterol at age 50 predicts cognitive health at age 70.
But hopefully we'll start to have more options and wider approvals for things like anti-amyloid drugs.
> anti-amyloid drugs
Isn’t the viewpoint in the last decade that amyloid plaques are likely a finding rather than the underlying cause of Alzheimer’s Disease?
That's the viewpoint of everyone sensible outside of Alzheimer's research.
Those in it are still throwing billions per year at the idea.
Meanwhile, back in reality, no amyloid-beta drug has had any clinical effect in humans, other than reducing the plaques. But both the shingles and RSV vaccines are proven to reduce Alzheimer's risk.
Which did not stop the FDA from approving a useless anti-amyloid drug, leading to the resignation of several experts, one of whom called it "probably the worst drug approval decision in recent U.S. history" in his resignation letter. [0]
I can't think of a good reason why this happened.
[0] https://www.npr.org/2021/06/11/1005567149/3-experts-have-res...
not really. your comment is a vast oversimplification of a very complicated topic.
The "standard" theory is that amyloid leads to tau protein accumulation which leads to neurodegeneration: https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h.... Which would explain why current treatments don't really work: by the time Alzheimer's has progressed to noticeable impairment there's already too much tau, so reducing amyloid will at best slow the rate of decline by reducing the formation of new tau.
> Which would explain why current treatments don't really work ... [they] at best slow the rate of decline
This is called working! I am struck by the double-standard applied to assessing treatment options for Alzheimer's vs cancers. Many (most?) Stage IV cancers are incurable, and the main goal of treatment is to slow progression of the disease. Adding years to patients' lives is absolutely worth it, assuming the side effects are not overwhelming and the costs are not prohibitive.
To wit: Moderna added ~30B to its market cap on the news that it observed _statistically significant_ improvement in its primary endpoint for treating metastatic melanoma. Great! I'm as excited about this development as anyone. A new treatment option for a terrible disease that meaningfully improves on the current standard of care (Keytruda). Sadly, Stage IV melanoma is still considered terminal, and no one suggested that Moderna changed that.
Why not reset expectations for Alzheimer's? If we manage to slow its development enough so that most patients (who tend to be elderly) would die of other causes while maintaining decent quality of life, that's a win in my book.
Hi there. Actually, Leqembi is a 1st gen Alzheimer’s drugs and targets amyloid plaques. But, like other responses, amyloids doesn’t seem to be hugely responsible for Alzheimers, which is why targeting things like tau proteins is being explored.
From TFA:
> Early detection of Alzheimer’s disease is important since the first treatments capable of slowing the progression of the neurodegenerative disease recently became available to patients, and these drugs are more effective when started sooner rather than later. Other promising investigational drugs are in the pipeline.
A very good friend's wife had Alzheimer's caught early, and the medication she's on stopped its progression. It's much better for her than my family members who had no treatment options.
Creatine supplementation is showing some promising indications of being a low cost, mild to moderate intervention https://www.psychologytoday.com/us/blog/the-modern-brain/202...
Whether this ends up being replicated or not, I love the classic gym bro supplement being studied for its potential benefits to the brain.
What a time to be alive
It's going to be replicated because we already know the mechanism of action. That said, many/most people would probably be better off solving the problem more upstream via whatever B-complex vitamins they need based on their bloodwork and DNA methylation variants.
I definitely wouldn't be sharing that as evidence of anything much at all
Google scholar link for the article https://scholar.google.com/scholar?cluster=10296105574478709...
what? there aren't any treatments that stop alzheimers, there are some that help manage symptoms
May not completely stop it, but lecanemab and donanemab are certainly considered to be disease-progression modifying at this point.
> the medication she's on stopped its progression
what medication is that?
I am not personally aware of any treatment for which there is particularly compelling evidence that it meaningfully slows progression even when started early. I wish there was.
It’s also not clear that one can measure progression well enough that an n=1 data point is meaningful. And I’m also far from convinced that very early Alzheimer’s that would progress rapidly enough to be noticeable can be detected with enough specificity to rule out fairly common cases of people who test positive but effectively don’t have the disease.
Best wishes to your friend’s wife.
Agreed that that it’s an interesting question on how to detect Alzheimer’s and also how to treat. My Dad is starting to show signs of mild mental impairment (he’s 87) - more forgetful than usual, more confused than usual, not able to work his computer like he used to…
He has taken a personal interest in preventing dementia and wants to take the first generation Alzheimer’s drugs, specifically leqembi that works on amyloid plaques. And this is definitely a tough choice, because eventhough it does show some slowing of the disease, it has lot of side effects that may not be worth it.
Personally, I am against it and don’t think it’s worth it as he could do permanent damage to himself. Think he should hang on until the second generation of drugs come out, which should be in the next 1-3 years (there a lot of Alz drugs in the pipeline, but you never know of course if anything will pan out). It’s a tough choice and don’t know if there is a good option at this point.
I'm sorry your dad is facing this disease. Hopefully he can find something that helps slow it. I don't know what the side-effects are that he could be facing but, as someone who lost a parent to alzheimers, let me say that anything is probably preferable to advanced-stage dementia. I hope to see real, reliable treatments in my lifetime.
Thanks for the info on this. Hmmm, maybe Leqembi isn’t such a bad option.
And, would be very surprised if none of the drugs in clinical trials panned out in the next five or six year. It seems like they’re on the verge of making a major breakthrough. Here’s hoping:)
The amyloid treatments slow cognitive decline by 35% or so for 18 months. Some papers argue (and I believe) the effect is small enough many patients don't notice or seem to benefit.
We shall see if yet another generation of amyloid-targeted treatment does any better. The amyloid-hypothesis boosters seem to think so - we had a thread about this not that long ago. But I remain skeptical.
It sounds similar to Lipoprotein(a) blood test for cardiac risk.
It's (almost) purely determined by genetics. You can't do anything to improve it, other than to improve every other cardiac related risk factor.
(There are some experimental drugs in the pipeline, though)
There is an oral PCSK9 treatment (enlicitide) was recently released that provides a 30% reduction, and of course you can't get insurance coverage without the test. And there are 2 drugs with 90%+ reduction in Lp(a) in phase3 trials with expected release in 2027-8, in particular Olpasiran.
We can also test for PSEN1, which is 100% accurate in determining early onset alzheimer's disease, quite a it more expensive, so unreasonable as a screening tool unfortunately.
I am skeptical of 100% anything, so did some looking:
>>Mutations in PSEN1 and APP are associated with complete penetrance, meaning that all individuals who have a PSEN1 or APP mutation will develop AD if they live a normal lifespan [1]
and
>>[Age-of-onset] Usually 40s or early 50s (range 30s-early 60s) [2]
Note that this is only for early-onset Alzheimer's, representing ~5% of all Alzheimer's.
>>Our study showed that the rate of EOAD in AD is 5.5%, not 1-2% as usually demonstrated. And our results indicated that the rate in developed countries was relative higher than in developing countries [3]
[1]https://pmc.ncbi.nlm.nih.gov/articles/PMC3326653/
[2]https://www.ncbi.nlm.nih.gov/books/NBK1161/table/alzheimer.T...
[3]https://pmc.ncbi.nlm.nih.gov/articles/PMC4356853/
I work directly in this field (clinically validated digital cognitive tests that characterize cognition, often paired with p-tau blood tests.) Ask me anything, I guess!
Generally, what progress is being made on Alzheimers ?
Are advances like AlphaFold likely to speed up progress ?
I see results like the OP as speeding up progress. Tests like ptau make it faster and cheaper to screen for participants in clinical trials. This allows more resources to be spent on pre-screening, to identify candidates that might be healthy at time of trial start, but who are likely to develop cognitive impairment during the trial, which can be helpful for better measuring efficacy etc.
There was a good, accessible guidelines paper in the Lancet that described helpful interventions at all stages of life to decrease the odds of developing cognitive impairment later in life.[0]
In terms of late-stage treatments to halt or reverse progression, that still seems very far away. The causes are so diverse... My father died of vascular dementia not too long ago, so I'm familiar with the caregiver side in addition to the business.
[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Why is the FDA "clearing" something that is completely innocuous like a blood test?
I think you need FDA clearance to be able to market a test as actually being effective for treatment/prevention etc. For exactly the same reason woo-woo supplements must disclaim that they aren't intended for that purpose
Because tests aren't completely innocuous? Because tests lead people to make significant medical decisions?
Look at the supplements world, where grifters are shilling chemicals that cause harm and make radical claims for absurd markups. Or gas station pills. You want those companies making Alzheimer's tests? People going in to a 7-11 and buying a "all illness test card" that tells people they do or don't have degenerative diseases?
No, it's very very important to ensure tests are actually indicative and ensure they are well made. To do that, a regulating body needs to be involved.
Their doctor should be qualified to make that judgment without a government bureaucracy evaluating the efficacy of the test on their behalf, unless you want to completely destroy the rate of medical breakthroughs. If there's no potential harm from the procedure itself, the government shouldn't be involved at all.
Imagine if every new AI model had to be "cleared" by a government regulator. The role of government in healthcare evaluation needs to be simplified and streamlined. The liability needs to be shifted to doctor, and if it's a case of charlatanism, that liability should include a lengthy prison sentence.
There is potential harm. That's the point.
So we should just let companies flood doctors with potential treatments and then hope they have enough time to figure out whats relevant for their patients?
Seems much better use of time and money to have people developing tests meet a pre-defined standard and after that point they're allowed to flood doctors with marketing for the tests.
What use is future medical advancements if it can't meet low bars like proving it works?
The problem is the FDA's pathetic throughput times. It takes them decades to approve drugs. Blood tests take 1-2 years on average. It's a huge bottleneck. If they could turn these things around faster and work iteratively, it would be different.
October[1] to August[2] isn't even a single year.
Definitely longer than I'd expect for "cleared" considering everybody involved should have to be licensed and pretty sure you pay a fee to the FDA so that should cover the cost of FDA hiring employees to just call each person involved to verify the submission is accurate.
Although IIUC, they were already allowed to do 50yr+ people and the recent clearance is just for 40yr+ so I'm not actually sure how uh impactful this is (a bit more confused why it takes 10 months to drop the age by 10 years).
[1]: https://precivityad.com/news/c2n-submits-us-fda-regulatory-f...
[2]: https://c2n.com/news-releases/bg2ziqcz39o3wxf5uc04u279ziw0yv
> "If there's no potential harm from the procedure itself"
There is potential harm from the procedure itself because of https://en.wikipedia.org/wiki/Opportunity_cost and https://en.wikipedia.org/wiki/Budget_constraint and because sticking needles in people and drawing blood carries inherent medical risks.
Some doctors absolutely would abuse this. I used to date someone whose sister was an endodontist and there was another endodontist in the building who was making over $1m a year. She ended up seeing one of that endodontist’s patients and realized that the other doctor had been making all that money by giving people medical procedures they absolutely did not need.
But only another medical professional would know that; the patients were completely oblivious. I said she should blow the whistle but she “didn’t want to rock the boat”. It definitely changed how I feel about doctors. There’s a massive level of trust there, which most doctors will honor but a few will exploit.
As long as we make examples out of the few that exploit, it will be a-ok.
Citation very much needed. Society today is full of people in power who exploit others. Cops, ceos, spouses, etc. Very rarely are they "made an example of", and when they are it doesn't seem to change the intuitions.
> Their doctor should be qualified to make that judgment without a government bureaucracy
This is like saying AI developers should be qualified to evaluate the effacy of a model without testing the model.
You're assuming that everyone has access to a doctor, and that people who do have doctors will visit them instead of just looking at their phone.
Google "what did theranos do" to find out why.
Google "how was theranos caught" to find out that an investigative journalist uncovered the fraud, and the FDA missed it.
Ah, so you are aware then.
It is largely about insurance reimbursement. Your health insurance won't likely cover something the FDA hasn't cleared.
Right, it's paperwork. I get it. Horribly inefficient paperwork.
It would be more efficient for every single insurance company to evaluate every single treatment and decide if they will cover it?
These tests are more or less useless because there's no treatment anyway so knowing about it a long time in advance will not lead to any substantial gain. Even slowing the disease isn't within the realm of today's technology. Today's pharmaceutical companies are close to quacks as far as Alzheimer is concerned. We know next to nothing about its origins or even how the disease progresses.
The only thing you gain is giving people more time to worry and despair.
Earlier diagnosis, or at least suspected diagnosis, could make a difference in studying progression, origin, etc.
Imagine the test is 100% accurate: if you gave it to a group of people, you could then try to make interventions earlier, capture more data about lifestyle before symptoms, etc.
Patients becoming involuntary guinea-pigs for science? No thanks.
As long as there isn't a clear root cause found and some real mitigating medicines reach the market I would propose keeping people ignorant as long as we can.
Taking an optional test is voluntary.
Entering a study for people who tested positively would also be voluntary.
Anecdotal responses in this topic indicate there may be some mitigatimg medicines.
Demanding a root cause before doing anything is silly. Finding root cause in biological systems is incredibly difficult; there's value in finding symptoms and managing symptoms without finding a root cause. And dangers of focusing too much on any one indicator.
That's not to say I suggest everyone be screened for everything. If there are limited mitigations, it's not appropriate for most people to be screened. But even if there are no medical mitigations, you might put your affairs in order with appropriate urgency if you knew your cognition would be much reduced in the next 5-10 years.
Who said involuntary? I'd imagine many people, if told they were likely to develop Alzheimers, would be eager to participate in lifestyle interventions or even trials for a potential treatment.
I think I'd want to know.
It would affect my financial and estate planning, and how I'd like to navigate the disease's progression.
This is an infuriatingly clueless comment. It gives nothing? It allows people to set their affairs in order, and that is an invaluable thing.
Alzheimers can lead to all kinds of other issues like impulsivity, or aggressiveness. People gambling away their life savings, not knowing that they are even doing it. Doctors unable to intervene due to rights around patient autonomy. All of this has big consequences in the lives of those affected.
When the symptons set on you'll have plenty of time to wind down your affairs.
And much less ability to handle the task.
These tests are not useless, but I’d agree (from personal experience) that it’s far from clear that everyone should take one.
There’s a degenerative genetic disease that runs in my family that for various reasons we only found out about ten years ago. To get the test done in the UK for it, you have to go to mandatory genetic counselling where they try to convince you not to get it done. Of four siblings, the two of us who thought initially we’d definitely get it done, we’ve not, and the two who were sure they wouldn’t, have done.
They try and convince you not to get it done so you don’t end up confusing being tired one morning or tripping with “oh my God it’s starting”.
Everyone should get their affairs in order, regularly, without needing a test, if they care about their loved ones.