Study Participants at Risk for Alzheimer's
want to know their potential fate
Newswise, December 12, 2011 —If you had
a family history of developing
Alzheimer's disease, would you take a
genetic test that would give you more
information about your chances?
"Definitely," said Gloria VanAlstine, 60,
and Joyce Smith, 79. The two women took a
controversial genetic test of a gene called
Apolipoprotein E. APOE is a susceptibility
gene where certain variants have been found
to significantly increase a person's risk of
developing Alzheimer's disease. Both women
have a family history of Alzheimer's, which
increases risk.
The genetic test was conducted as part of
the Risk Evaluation and Education for
Alzheimer's disease Study (REVEAL), a series
of clinical trials taking place at U-M
School of Public Health, with other sites
including Harvard University, Howard
University, and the University of
Pennsylvania.
APOE testing is controversial in the medical
community because the variant is neither
necessary nor sufficient to cause
Alzheimer's disease. This limitation, along
a with a general lack of treatment options
for Alzheimer's, has raised concerns that
the genetic information could burden rather
than benefit patients. There have been
numerous consensus statements and articles
against using APOE genotyping for predicting
Alzheimer's risk.
However, most of the study participants who
took the test, including VanAlstine and
Smith, wanted to learn about their APOE test
results and were not overtly distressed by
them, said Scott Roberts, associate
professor in U-M SPH, and co-principal
investigator of REVEAL, along with Robert
Green at Harvard University School of
Medicine.
The National Society of Genetic Counselors
and American College of Medical Genetics
recently developed practice guidelines for
genetic counseling and testing for
Alzheimer's disease. Roberts is one of the
authors.
The guidelines provide clinicians with a
framework for assessing their patients'
genetic risk for Alzheimer's disease,
identifying which individuals may benefit
from genetic testing, and providing the key
elements of genetic counseling. Alzheimer's
disease is traditionally subdivided into
early onset and late onset types. Early
onset occurs before age 60–65 years and
accounts for 1 to 5 percent of all cases,
while late onset occurs after 60–65 years
and is the predominant form.
For more on Roberts:http://hbhegenetics.sph.umich.edu/people/scott-roberts
The University of Michigan School of Public
Health has been working to promote health
and prevent disease since 1941, and is
consistently ranked among the top five
public health schools in the nation.
