ANN ARBOR, Mich.—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
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 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.
This article was first published at www.newswise.com