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A Test for Alzheimer's Disease Raises Thorny Ethical Issues

Experts weigh in on value of knowing without availability of effective treatments

A changing landscape

The flurry of headlines that greeted the announcement of a new blood test gave the impression that it was just around the corner. It isn't. The preliminary results must first be confirmed by other independent research teams. Even then, says Mark Mapstone, an associate professor of neurology at the University of Rochester Medical Center and another member of the team that developed the blood test, it "would likely be used in high-risk individuals" — people with a family history of Alzheimer's, for instance.

By that time, researchers say, they are likely to know much more about Alzheimer's disease and even how to slow its progress. The blood test already offers important clues, according to Federoff. The changes that have been observed in the blood are believed to result from the breakdown of brain cell membranes in people destined to develop the disease. The researchers are continuing to look at other molecules in the blood that would give a more detailed glimpse into what goes wrong in people at risk.

In other research, scientists are recruiting volunteers for a program called the A4 Study, which will test an experimental drug that could slow cognitive decline in people who are at risk of memory loss because of Alzheimer's. Researchers at Harvard Medical School recently announced that a naturally occurring protein may protect against the development of Alzheimer's disease and age-related dementia — and these findings could open up a new area of treatment.

"As long as there is no effective treatment, there's a real question about whether to offer a test," says Klugman. "But once we have ways to slow or stop the disease, there are many fewer reasons against testing."

Peter Jaret writes on health and medical issues for national publications.

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