Should You Be Able To Take an Alzheimer’s Test at Home?
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Should you be allowed to take a blood test that could tell you if you’re already at risk of Alzheimer’s disease? Last year, Quest Diagnostics began offering a consumer-initiated blood test for $399 (not covered by insurance) that detects the buildup of proteins associated with the development of Alzheimer’s in customers’ plasma. Under pressure from other biomarker researchers and the Alzheimer’s Association, Quest no longer offers its test to consumers. But other such tests are poised to come to the consumer market.
Prior to the advent of the new blood biomarker tests, clunky and expensive brain scans and spinal taps could confirm an Alzheimer’s diagnosis only after a person was already experiencing the cognitive symptoms of the illness. The new biomarker tests can alert users to their risk as much as 10 years before symptom onset.
The Quest test was targeted to people over age 50 with a family history of Alzheimer’s and to those worried that their memory is becoming impaired. Critics properly argued that the Quest test’s false positive rate (that is, the rate at which it incorrectly diagnoses someone as being at greater risk) is too high. But this objection will soon be moot as more highly accurate tests become available.
Some physicians and bioethicists are cautious about allowing people to have access to this information. Some physicians worry that users will misinterpret test results and overwhelm neurologists’ offices in a diagnostic rush. Some bioethicists suggest that people testing at higher risk would experience psychological distress, might suffer social stigmatization, and could encounter biomarker discrimination in work, housing, insurance, and access to long-term care.
This is not the first time direct-to-consumer testing to identify a person’s risk of developing dementia has been contested. In the early dawn of genetic testing in the 2000s, lots of physicians and bioethicists opposed allowing people to take genetic tests identifying genes that boost a person’s lifetime risk of developing Alzheimer’s by fourfold to twelvefold.
Now such direct-to-consumer genetic testing is widely available, with little evidence that test-takers are overwhelming the health care system, suffering significant discrimination, or experiencing untoward psychological downsides. A 2023 review article in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, found that “there was no short-term psychological impact of sharing biomarker status, implying it can be safe.”
“I personally would not elect to know if I had plaques in my brain,” the prominent Alzheimer’s researcher Gil Rabinovici told The New York Times in March. He then correctly noted that “we’ve graduated from the notion that the doctor determines who learns what.”
The Alzheimer’s
Article from Reason.com
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