I was on NPR and I stumbled upon a story published April 19, 2011 (serendipitously during Neurodegenerative week) about updating guidelines of diagnosing patients with Alzheimer's. Previously diagnosing those with the disease was done after the fact without any indication if a person was likely to develop the disease. Now an initiative being backed by the National Institute on Aging and the Alzheimer's Association, is urging doctors to tell patients whether or not they are likely to develop Alzheimer's by monitoring brain shrinkage, plaques in the brain, and modifications of CSF.
I think there are pros and cons.
One pro that is mentioned in the article is that those who are deemed highly likely to develop the disease, have more time to setup healthcare arrangements (i.e. hiring an at-home medical attendant, saving money, etc.). That way patients and their families will have more time to prepare for the subsequent series of unfortunate events.
Another pro mentioned in the article is that those who are placed in the "highly likely" category may be targets for experimental approaches at dealing with the disease down the road.
One con mentioned was that if people are labelled highly likely, then they may go through some deleterious psychological events.
Another con that I thought of, relates to insurance coverage. If someone is deemed highly likely to develop the disease he or she may be denied healthcare insurance coverage. This is extremely unfortunate but because of the recent economic decline, companies are trying to cut costs wherever they can and implementing stricter coverage guidelines. As a result, implementing this system of earlier Alzheimer diagnosis could potentially prohibit some patients from receiving care.
http://www.npr.org/2011/04/19/135548317/scientists-update-alzheimers-guidelines
I see a problem with the second pro mentioned here - that a "highly likely" patient category could be a target for experiments later down the line. Like already mentioned here, simply knowing you are likely to develop a disease may have serious consequences on the human psyche. I fear as though the mental decline that results from this could confound any results obtained from experiments on the "highly likely" group. How could scientists differentiate between the two types of mental decline?
ReplyDeleteThat is a good point.
ReplyDeleteOne thing that I thought of would be to continually monitor mental alterations associated with aging throughout a patient's life using various imaging techniques. Thereafter, if a physician notices plaque buildup, brain shrinkage, or other alterations that seem to be occurring at a more advanced rate than before, maybe those patient's can be considered highly likely.
I agree with Julia, it could be very detrimental to ones psyche and emotional well being knowing that they are "highly likely" to develop Alzheimers. I think there are other disease where this type of categorization would be more helpful, for instance diseases where you can take more concrete preventative measures. As an example I know several of my family members have gotten skin cancer and have had scares with melanoma. I can take concrete measures to prevent this by wearing sunscreen or getting dermatology checks more often. With Alzheimers, and many of the other diseases we have talked about, there aren't many concrete measures one can take to prevent them.
ReplyDeleteI do appreciate the con you added about insurance coverage. Once we start categorizing people for their likeliness to develop a disease, I feel very few people would be able to get coverage.
I agree with Brianna, there should be other preventitive measures for other diseases that are more treatable, such as diabetes. I am skeptical of this early detection, in terms of brain scans searching for plaque build up, because this essentially the beginning of the disease that has no cure. Further, I would be afraid of insurance compainies dropping their clients for pre-existing conditions if they are classified as "highly likely" to develop AD.
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