To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Advanced Genetic Test May Be Useful for Alzheimers Diagnosis URL: http://www.pslgroup.com/dg/7A46.htm Doctor's Guide April 19, 1996
LOS ANGELES, April 19, 1996 -- Testing for the APOE gene may be useful in diagnosing Alzheimer's disease in people displaying symptoms of dementia, when used in conjunction with other tests, according to the Los Angeles Alzheimer's Association. However, APOE testing needs to be further evaluated for its applicability, cost-effectiveness, and impact on health care and the community before its use becomes more widespread, according to the association. Such evaluation is underway. A paper published in the April 20 issue of the journal Lancet summarizes consensus statements developed at a Conference on Apolipoprotein E Genotyping in Alzheimer's Disease held in Chicago in October 1995. The event was co-sponsored by the Alzheimer's Association and the National Institute on Aging. "As the APOE test is commercially available now, it is important for physicians to learn the applicability and limitations of the test so they can best advise patients and families of its value," said Peter Braun, executive director of the association. "If used, APOE testing should be part of a full diagnostic evaluation, and not be used alone to diagnose Alzheimer's. "Most importantly, APOE testing should not be used to predict the risk of developing Alzheimer's disease in adults who have no symptoms," Braun said. The Lancet paper states: "The usefulness of APOE genotyping for predicting risk of (Alzheimer's disease) in asymptomatic individuals has not been established in longitudinal population-based studies and as such is not recommended...at this time." There are several reasons the APOE test should not be used as a predictive test. People who carry the APOE-e4 gene, considered a risk factor for Alzheimer's, may not develop the disease. And, people who do not carry APOE-e4 may still develop Alzheimer's, so not having APOE-e4 does not mean that individuals are risk-free. Since the APOE test cannot be used for prediction, sharing test results may be unduly alarming or comforting to the individuals being tested, according to the association. The Lancet paper recommends that "adequate pre-test and post-test counseling, education and psychosocial support" be provided with all applications of APOE testing. "Counseling should include a full discussion of the implications of the test for patients and their families, and provide people with all the information they need to make an informed decision about whether to take the test," Braun said. The association released its genetic testing principles for health professionals and policy makers in June 1995. "The discovery of the association between APOE and Alzheimer's disease is one of the most important research advances," Braun said. "Preliminary research indicates that the types of APOE genes a person inherits may also affect the age of onset of the disease. This gives us greater confidence that, in the future, we may be able to intervene to delay the onset of the disease." One of the goals of the Ronald and Nancy Reagan Research Institute, launched by the association in November 1995, is to postpone the onset of Alzheimer's. Pushing back symptoms by five years will reduce by 50% the number of people with Alzheimer's and save this country as much as $50 billion in healthcare dollars, according to the association. The relationship between APOE and Alzheimer's was first reported in 1993. Three variations of the APOE gene have been identified, known as e2, e3, and e4. The APOE test determines which types of APOE an individual has inherited. APOE-e4 is now considered to be a major inherited risk factor for Alzheimer's, but the mechanism by which it predisposes people to Alzheimer's is not yet understood and is a focus of intense and wide-ranging research. The Alzheimer's Association is the only national voluntary health organization dedicated to conquering Alzheimer's disease through research, and to providing support and assistance to those afflicted with the disease and their caregivers. The association is the largest private funder of Alzheimer research. There are an estimated 140,000 Alzheimer's patients in Los Angeles. For more information about Alzheimer's disease, call the Los Angeles Chapter of the Alzheimer's Association at 800/660-1993. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. 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