Today’s news of a new and accurate way of diagnosing Alzheimer’s disease through a spinal fluid test is both promising — and troubling.
Researchers writing for the Archives of Neurology told of a nearly 100-percent accurate test of cerebrospinal fluid for biomarkers that signal Alzheimer’s disease. The disease was confirmed in some of the study subjects through an examination of the brain after they died. What surprised the scientists was the presence of the Alzheimer’s disease signature in more than one-third of the cognitively normal subjects–suggesting that the disease “pathology is active and detectable earlier than has heretofore been envisioned,” the abstract says.
Dr. Steven DeKosky, dean of the University of Virginia medical school, told The New York Times “this is what everyone is looking for, the bull’s-eye of perfect predictive accuracy.”
Most experts believe that Alzheimer’s starts before symptoms become obvious, so having a way to identify victims early might lead to ways of slowing or preventing deterioration. Lots of drug studies are in various stages of experimentation and development for that purpose.
Here’s what’s a little troubling: Should doctors offer, and should patients accept, a test for a disease that has no treatment?
An accompanying editorial tackles this issue.
My thinking has always been that more information is better than less. However, as patients, we have to ask ourselves, what will we do with the information?
Say we are having memory troubles and fear Alzheimer’s. Would having such a test done (once it’s ready for prime time, that is) alleviate our fears? If the results said no, would it encourage our doctor to explore other causes? If the results said yes, would knowing that make things worse for us–especially now, when there’s really not much that can help someone in the early stages of Alzheimer’s?
Maybe there will come a day when such a spinal fluid test would become something of a screening, like a mammogram to spot breast cancer or a colonoscopy to spot colorectal cancers. But we’re not there yet.
My other concern would be that a long term care insurance policy be firmly in place before the test. Because once someone is diagnosed with a dementia, good luck purchasing coverage. The costs of caring for someone with dementia are enormous. Without that coverage, I honestly don’t know how we would have cared for my father.