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Is knowledge always power?

Created date

March 22nd, 2011

Matt Narrett, M.D., is chief medical officer for Erickson Living and directs the provision of medical care at all Erickson Living communities. He received his medical degree from Harvard Medical School and is board certified in internal medicine and geriatrics. He is coauthor of Old Is the New Young, a guide to successful aging (available on amazon.com). '

If you could find out years before you ever develop symptoms whether or not you are at risk of developing a disease, would you want that knowledge? It is now easier than ever to obtain early knowledge about your health risks through a simple blood test which can determine if you have a genetic predisposition for a disease. And with that knowledge, you may be empowered to take steps to prevent illness later in life. For instance, if genetic testing suggests you are at risk for heart disease, you can reduce that risk by controlling your cholesterol, eating a heart-healthy diet, exercising, or taking medication. If results show an increased risk of developing diabetes, you can have your blood sugar monitored and also make lifestyle modifications to reduce your risk of ever developing the disease.

Alzheimer s testing trickier

But unlike heart disease and diabetes, if your tests indicate a predisposition for Alzheimer s disease, there is no strong evidence that you can take this newfound knowledge and change your lifestyle, take vitamins, or use a particular medicine to prevent or treat it. Although some studies show that increasing your physical activity, exercising your brain, and staying socially engaged may reduce the risk of developing dementia, there is no clear evidence (as with heart disease) that taking these actions will prevent the disease. So given our relatively limited understanding of Alzheimer s disease, does genetic testing make sense? The answer among experts in the medical community varies. Some say yes for any individual who s interested in knowing. Some say yes, but only for individuals with a family history of Alzheimer s. And some say no because it is premature to share the results without a better understanding of how to interpret these tests.

Mixed reactions

Researchers who have been trying to answer the question of whether or not to disclose the outcome of Alzheimer s testing have found results that one might expect: Individuals who test negative feel relieved and have a significantly lower level of test-related distress than individuals who test positive for Alzheimer-related genes. Interestingly, test-related distress was not elevated for individuals who had positive results for conditions like diabetes or heart disease perhaps because these conditions can be potentially prevented and treated. Needless to say, decisions to undergo genetic testing for conditions like Alzheimer s disease need to be carefully considered and should be discussed with your physician and those who know you best. Such decisions are intensely personal, and it is essential to weigh the impact of a potential positive result. In good health, Dr. Narrett

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