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Alzheimer's Test

Saturday, 16 October 2010  | Denise Cooper-Clarke

"I hope I die before I get old"
The Who, My Generation)

Watching the inexorable progress of dementia in someone close can be heartbreaking. From slow thinking, forgetfulness and irritability, he or she becomes confused and unsafe, behaving inappropriately, then loses the ability to understand or use speech, becoming incontinent, totally dependent on others, with no recognition of even a spouse or their own children and finally becomes bedbound and unconscious. This may take up to ten years. Even more distressing for some is the frequent apparent change in personality or even character: a kind, thoughtful, godly person may become self-centred, aggressive, paranoid, even abusive and blasphemous. Observing these changes in others, one can’t help but wonder if this is what the future holds in store for us, too. And we may well wish to die before that happens.

Medicine has prolonged our life span, but one in four people over 85 have dementia, with Alzheimer’s disease being the most common form. Rather than a non-specific dread of the disease and hoping for the best, would you want to know for sure that you would develop Alzheimer’s (or not)? According to a study published in Archives of Neurology August 2010, analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture may now accurately predict the development of the disease, up to ten years before any symptoms appear.

But would you want to know in advance that you were going to develop Alzheimer’s?

For conditions where there is effective treatment, there is a great advantage in early diagnosis- hence cancer screening programmes. But there is currently no effective treatment for Alzheimer’s. On the plus side, being forewarned might prompt you to put your affairs in order- spiritually, relationally, financially, and to plan for your future care. Coming to terms with one’s mortality and human frailty might be an opportunity for growth in faith, a deepening of relationships and of dependence on God. But for those without faith, or those who lack meaningful relationships, the burden of such a bleak future might be overwhelming. A positive test could lead to anguish, despair or even suicide. And what if some test results are false positives and the person would not have developed dementia? On balance, it might be considered better not to know. To avoid the anxiety, to simply take life “as it comes”. We might consider Jesus’ words, “Can any of you by worrying add a single hour to your span of life?... So not worry about tomorrow. For tomorrow will bring worries of its own. Today’s trouble is enough for today.” (Matthew 6: 25-34)

On the other hand, there is a strong argument for testing at least some individuals, since those who test positive could become a research cohort for trials of potential therapies and this could lead to the discovery of treatments which prevent or slow the progression of the disease to the symptomatic phase. Once such treatments were available, there would be a clear advantage in testing and early diagnosis.

Finally, there are other considerations at a public policy level about the advisability of widespread or even routine use of such a test. Who else should have access to the results? Will we be able to prevent the information from being used against people? For example, by employers or insurance agencies? If information is power, that power may be wielded against us as well as by us.


Rowena DUNK
January 1, 2011, 10:38AM
You probably know as you are entering it but then it becomes too late. Having observed it in my own family I have opted for palliative care and made my wishes known. It is our families who grieve for what they have lost. Our times are in God's hands & you do not know when that time will come. A sudden illness may come & take a person & the end may be different to what the human expectation was. Don't try and foretell. Don't play God. Look after & care for your relatives, even as they did for you when you were an infant, without a mother's care we would not grow up.

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