On Thu, 22 Jul 2010 22:54:41 -0700, Michael Sylvester wrote:
>Recently there have been speculations about detecting Alzeimers,
>autism,and other pathologies as early in life as possible.

As these disorders become better understood and the basis
for why they occur, especially genetic, is identified, it will 
become easier to predict who is at risk and what strategies 
to follow to deal with the condition. This has been done in
that past and will be a useful strategy to follow in the future.

>Re Alzheimers,researchers think that there are biological markers
>that can be detected very early in life and preventative treatment can be 
>applied.I find this idea crazy.

I don't understand why you find this idea crazy.  Consider the
case of Huntington's chorea/disease which has some similarities
to Alzheimers but is much better understood.  For example, see:
http://www.nlm.nih.gov/medlineplus/ency/article/000770.htm

The genetic basis for Huntington's is well understood as are the
different ways in which it can be manifested (e.g., early versus
late onset).  Moreover, we know what the probabilities are for
the development of Huntington's in a family.  Quoting from the
above source:

|If one of your parents has Huntington's disease, you have a 50% 
|chance of getting the gene for the disease. If you get the gene from 
|your parents, you will develop the disease at some point in your life, 
|and can pass it onto your children. If you do not get the gene from 
|your parents, you cannot pass the gene onto your children.

Woody Guthrie developed Huntington's disease and Arlo Guthrie
was afraid that he would develop it until, I believe, genetic testing
showed that he did not have the gene. Wouldn't you want to know
whether you had the gene?  Would you want to have children
without this knowledge?

>For one thing,it may increase the potential Alzheimers pool in the 
>population and  that could be an unnecessary vague premonitions 
>of disaster.

Now this sounds crazy.  The "potential Alzheimers pools" depends
upon (a) how strong a genetic basis there is for the disease, (b) whether
certain environmental events are necessary for the disease to develop,
and (c) other factors that interact with (a) or (b).  If Alzheimers is like
Huntington's, then knowing what the genetic basis is, what proportion
of the population is at risk, and other factors will help to guide strategies
for dealing with it.

"Vague premonitions of disaster" is a poor excuse for not knowing
what one's risk is for developing an illness though some people may
not be able to deal with it for whatever reasons, comparable to the
person who engages in promiscuous unprotected sex but doesn't want to
get an HIV test because the person is afraid of learning that they may
be infected as well as having to change their behavior (which they may
feel disinclined to do).  Such people need a good talking to.

>The other issue -how can one predict such a bio-cognitive-behavioral
>outcome for thirty or forty years down the road? 

There are a number of genetically based illnesses like Huntington's that
can be diagnosed with genetic testing, diseases like Tay-Sachs (see:
http://ghr.nlm.nih.gov/condition/tay-sachs-disease ) and others (see:
http://ghr.nlm.nih.gov/BrowseConditions

The prognosis for these and other conditions is well-known. For 
Huntingtons, the prognosis is bleak:  quoting from the above website:

|Huntington's disease causes disability that gets worse over time. Persons 
|with this disease usually die within 15 to 20 years. The cause of death is 
|often infection, although suicide is also common.

>and how confident can they be that it was their treatment that prevented 
>the onset of Alzheimers?

Perhaps you should spend some time going over the research literature
for medical treatments.  It is not clear that a cure or effective treatment
for Alzheimers will be available in the near future but this doe not mean
one cannot be developed.

Treatments for conditions like Alzheimers and Huntingtons and other
diseases depend upon the development of valid scientific knowledge
and understanding of the diseases as well as some luck and creative
insight into the essential problem represented by these diseases. The
fact that we have been able to develop effective treatments and vaccines
for a large number of illnesses suggests that we should have cautious
optimism for the similar developments for other diseases.  

Few people today remember the fear that polio inflicted on people prior 
to the develop of the polio vaccine (although I was very young at the time,
I still remember TV public service commercials warning about polio
before the vaccines became available).  A PBS documentary highlights
this period of time; see:
http://www.pbs.org/wgbh/americanexperience/films/polio/
A transcript of the program is available here:
http://www.pbs.org/wgbh/americanexperience/features/transcript/polio-transcript/

One can hope for similar success for HIV, Alzheimers, and other diseases.
These are empirical goals that scientific medical research can rightly strive 
for. 
That's not a crazy thing to do.

-Mike Palij
New York University
[email protected]



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