I find Mike's analogy between Alzheimer's and Huntington's quite inappropriate. We have known for eons that Huntington is caused by one dominant gene and if that gene is in one's genotype, it will be in their phenotype, period. In contrast, the factors that contribute to the development of Alzheimer's are not nearly as clear-cut. For example, as well as genetic susceptibility, there is clear evidence that factors in one's life experiences, as level of academic achievement, keeping very active, having a very supportive social network and maintaining a healthy diet high in lycopene and folic acid are associated with low levels of Alzheimer's (see Nun's Study:http://www.stpt.usf.edu/~jsokolov/agealzh2.htm)
Also as Dr. Pimplikar states in his NYT's op-ed piece, the tests for Alzheimer's, as the search for biomarkers, PET Scan and spinal tap are not yet able to predict well who will and who will not get this disease. http://www.nytimes.com/2010/07/20/opinion/20pimplikar.html I'm totally baffled at the inclusion of HIV that is clearly caused by sexual patterns and general health--who believes that HIV has a genetic cause?! But the more important issue here is the idea genetic tests can provide people with a clear idea of their chances of getting Alzheimer's when such is not the case at all. I feel that the medical establishment is showing their ongoing tendency to push for tests and more tests regardless of the long-term impact on the patient. Joan Joan Warmbold Boggs [email protected] > 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] > > > > --- > You are currently subscribed to tips as: [email protected]. > To unsubscribe click here: > http://fsulist.frostburg.edu/u?id=49240.d374d0c18780e492c3d2e63f91752d0d&n=T&l=tips&o=3765 > or send a blank email to > leave-3765-49240.d374d0c18780e492c3d2e63f91752...@fsulist.frostburg.edu > > --- You are currently subscribed to tips as: [email protected]. 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