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Simple blood tests may soon be able to deliver news about your cognitive health

102 points| helloworld | 8 years ago |nytimes.com | reply

56 comments

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[+] otakucode|8 years ago|reply
Does 'simple' mean 'you can buy it in Amazon and perform it in the privacy of your own home'? Because needing to book an office visit with someone who has had about a decade of medical training just to get the test done is not exactly 'simple' in my book. And sharing those results with the increasingly invasive systems of insurance and government and otherwise doesn't fill me with anticipation.

Overall I definitely do want to know, though. If I know that I am highly likely to contract dementia I can start doing things to attempt to combat it, or at least plan 5 or so years before that point to begin using hard drugs. You don't get any money back if you leave your body in good shape. I'd prefer to slide it smoking and smouldering across the finish line, missing both bumpers and with only one headlight hanging out. Then explode.

[+] JamesBarney|8 years ago|reply
It's a heck of a lot simpler than a brain autopsy, or a spinal tap.

And the real breakthrough isn't about people being able to know their demise, it's that they're are a lot of things that we suspect from a epidemiological perspective lower rates of alzheimer's but which have no effect once the disease is progressed.

[+] frankling_|8 years ago|reply
Nicely put. However, it does take some excellent judgement to avoid an extended crawl across the last few meters.
[+] jashper|8 years ago|reply
I for one will heartily join you at that finish line... hopefully a bit farther than we think it may be.
[+] of|8 years ago|reply

[deleted]

[+] _m8fo|8 years ago|reply
There are three realities:

1. The actions you should take if you knew that a serious disorder was coming for you will probably be beneficial one way or another.

2. There is nothing you can do about Alzheimers.

3. The only reason you wouldn't live the best, healthiest life you could now is because of an incorrect notion that you'll probably be fine until some set time (e.g. retirement)

Knowing these things, and the fact that stress has a negative effect on your health should compel anyone who reads the article to just live a sustainable life.

Since everyone dies and everyone knows it, the priority should be on living a nice life, free from the illusion that you'll live any given duration. Ideally, being diagnosed with something like Alzheimers would result in a shrug, just like how you would shrug if someone told you you're gonna die one day.

[+] dsp1234|8 years ago|reply
Alzheimers would result in a shrug, just like how you would shrug if someone told you you're gonna die one day.

Alzheimer's isn't like being dead though. It's an incredibly painful reminder to everyone you've every loved that you are no longer "you", but they have to take care of you every day anyways. Painfully re-opening wounds every time you don't remember who they are, or hurt yourself from confusion. It's a continuous living purgatory for your loved ones, with you gone but not gone.

I'd rather live the best, unhealthiest life, and hope I'm dead dead from other causes before I can cause so much pain to the ones I love.

[+] gozur88|8 years ago|reply
>Ideally, being diagnosed with something like Alzheimers would result in a shrug, just like how you would shrug if someone told you you're gonna die one day.

That isn't reality, though. I wouldn't want to have that big black cloud hanging over me.

If I'm not having symptoms, and there's no way to treat the disease they want to test for, I've no interest in taking the test. Life is stressful enough.

I knew a guy who was diagnosed with cancer, freaked out, and had a fatal heart attack a few days later. Maybe that was already in the cards, but I suspect he'd have lived for a few more years without that cancer diagnosis.

[+] llamataboot|8 years ago|reply
I have this variant. AMA

(It hasn't been traumatic knowledge for me -- anyone with severe dementia in their biological family knows that there is some heredity there, whether or not they know they have this particular gene variant)

[+] bri3d|8 years ago|reply
I also learned I have one variant (not two) and was already fairly aware as well due to my family history. I already live as healthy a life as I can and focus on enjoying it. Can't really do much of anything else.

To me the greatest benefit of this knowledge is being able to prepare loved ones and family for the inevitable - beyond that, there's not really much to be done and the knowledge hasn't really impacted me much.

[+] shazam|8 years ago|reply
How old are you?

Would you have wanted to find out if you were in your 20's?

[+] ams6110|8 years ago|reply
Get my affairs in order, then arrange for a quick death. I have no desire to become a burden on my children or anyone else.
[+] mythrwy|8 years ago|reply
Due to a bug in our system we inadvertently provided some of our users with results from other patients.

Point being, watch the weather and plan, fine, but don't become certain until you see rain falling from the sky.

[+] petercooper|8 years ago|reply
I sympathize with this viewpoint, but I need to play devil's advocate a little, to highlight the problems with predictive diagnoses:

Most Americans with this genotype go on to develop late-onset dementia.

Let's say "most" is 90%. Let's also say the accuracy of this test is (and I don't know if this is realistic or not) 98%.

Does the 11.8% chance of no dementia on a positive result give me enough to follow through with a plan? For me, no, though I appreciate attitudes would vary.

[+] chiefalchemist|8 years ago|reply
Pardon the editorial (I realize it's not very HN) but this type of fear mongering fluff does the public more harm than good.

The point being epigenetic is real. It does the general public more harm than good to perpetuate the myth that they (via lifestyle, diet, etc.) have no say in their genetic destiny.

No doubt sometimes some of these genes really matter. But often they are dormant notes of what might be if you don't take care of yourself.

p.s. I just finished reading "Grain Brain." Regardless of what you think about gluten, he makes very strong case for: where you take your body, your brain is going to follow. He mentions Alzheimer's often.

[+] Danihan|8 years ago|reply
>p.s. I just finished reading "Grain Brain." Regardless of what you think about gluten,

It's not just gluten. Look into enrichment. https://cdn-images-1.medium.com/max/1600/0*pBs90R1LfdGOfpTS....

Most people are actually sensitive to the additives added to fortified wheat sold in the States, especially Vitamin B[0] and Iron[1].

[0]: https://freetheanimal.com/2016/05/enrichment-promotes-everyt...

[1]: https://freetheanimal.com/2015/06/enrichment-theory-everythi...

[+] ninjakeyboard|8 years ago|reply
I eat centrophenoxine and racetams and meditate ~daily. I quit drinking/using anything stronger than caffeine. Try to be good to myself.
[+] amelius|8 years ago|reply
Wow, just read this on Wikipedia:

> Meclofenoxate (centrophenoxine), as well as DMAE, have been found to increase the lifespans of mice by 30–50%, and thus may be anti-aging drugs/supplements.

Are you taking it for a specific reason? Or do you consider this a generally good supplement?

[+] bdamm|8 years ago|reply
How long have you been taking Centrophenoxine?
[+] intro-b|8 years ago|reply
same as me, in addition to daily aerobic exercise, a lot of walking, and trying to maintain a strong social circle
[+] jjawssd|8 years ago|reply
Can Alzheimer's disease also be known as Type 3 diabetes?

"Brain insulin resistance (diabetes) is very much like regular diabetes," de la Monte said. "Since the underlying problems continue to be just about the same, we believe that the development of new therapies would be applicable for all types of diabetes, including Alzheimer's disease, which we refer to as Type III diabetes."

Suzanne M. de la Monte, Edward Re, Lisa Longato, Ming Tong. Dysfunctional Pro-Ceramide, ER Stress, and Insulin/IGF Signaling Networks with Progression of Alzheimer’s Disease. Journal of Alzheimer's Disease, June 22, 2012, supplement; DOI: 10.3233/JAD-2012-111728

Same author four years prior:

"brain insulin resistance is sufficient to cause AD and that additional significant abnormalities, such as ongoing DNA damage and mitochondrial dysfunction, are required."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/

[+] trendia|8 years ago|reply
Your last quote is the opposite of what the paper says. The authors write that insulin resistance is not sufficient to cause AD and that other things are required:

> Therefore, T2DM and obesity may contribute to, i.e., serve as cofactors of AD but by themselves are probably not sufficient to cause AD. Moreover, the findings in the T2DM/obesity model indicate the unlikelihood [emphasis here] that brain insulin resistance is sufficient to cause AD and that additional significant abnormalities, such as ongoing DNA damage and mitochondrial dysfunction, are required.

[+] hourislate|8 years ago|reply
I know genetically for some this may be unavoidable but perhaps by living a healthy life you could delay it to a point where you would pass away before it took over.

Obesity, Insulin Resistance, have been linked to this disease/condition. Maybe regular fasting, exercise, taking supplements (Lions Mane come to mind), CBD oil, coconut oil, medications like Metaformin, etc might help. It would be worth a shot since there are no real alternatives at the moment.

[+] 0xcde4c3db|8 years ago|reply
That might have the opposite effect, since Alzheimer's rates go up ~exponentially after age 65 or so.
[+] tequila_shot|8 years ago|reply
If I knew Alzheimer's were coming for me, I'd start meditating now. I currently do mindful meditation everyday, and have been doing since 2008.
[+] Buttons840|8 years ago|reply
I've had the same thought. I don't know that the meditation would slow down dementia, but I could hopefully cultivate mindfulness and cheerfulness, lest I become more and more frustrated at the world as I begin to lose comprehension of it. Also, some good drugs would be nice too.
[+] shazam|8 years ago|reply
there is no drug or lifestyle strategy that is absolutely guaranteed to protect the brain
[+] mhkool|8 years ago|reply
I am getting a bit irritated when I read the news about Alzheimers since for a couple of years there is a treatment which was developed by Dr Dale Bredesen. Dr Bredesen looked at all factors which were linked with Alzheimers and combined many together into a treatment strategy. He also defined 3 subtypes of Alzheimers. The result is that his treatment cures 9 out 10 patients with mild Alzheimers. The fact that Bill Gates invests in new drug treatments is insane.
[+] arikr|8 years ago|reply
Does anyone know an ETA on when this may be usable?
[+] LordHumungous|8 years ago|reply
Why would you ever want to know this.
[+] intro-b|8 years ago|reply
for me, using 23andme and other components of genetic testing related to health risk factors (all four of my grandparents passed away from or are currently battling cancer) helped me make some long-term decisions regarding my habits and lifestyle, and it did influence my decision to go into a healthcare-related field as a career. I like to think of it more as "I'd like to know what I'm up against," rather than "I have a morbid curiosity about what non-accident deaths will most likely happen to me"
[+] alakin|8 years ago|reply
because you could spend a tiny amount of effort/time to search for a newly available treatment to prevent the worst case scenario
[+] jksmith|8 years ago|reply
I'd fly to Africa, walk out into a herd of Cape Buffalo, and slap one of those bastards right in the face as hard as I could. Why people want to live forever is beyond me.
[+] adventured|8 years ago|reply
> Why people want to live forever is beyond me.

I have the same reaction when someone says they only want to live ~80 years. What a terrible outcome when the universe is so massive. There's so much to see, do, try, experience and learn.

There are trillions of galaxies out there and every one of them is different. I could easily happily fill thousands of years just in our solar system.

I'd like to live long enough to explore other solar systems and galaxies and yet the earth by itself is far too large to ever meaningfully explore in a few lifetimes, much less one.

I simply want to see what all is out there. Now, granted, plenty of people consider that a very selfish desire (based on a scarce resources premise) and I'll openly admit to that. It's about as selfish a desire as there can be. I'm ok with that, it's also not a desire that can be actual (not in my lifetime anyway). As such it's equivalent to wanting to be able to fly around like Superman. My desire to learn and experience more will never halt, as such my desire to live an extremely long time will never cease.

[+] rhaps0dy|8 years ago|reply
You might want to look for a less painful and less expensive suicide method, and then proceed to not suffer and donate the money saved to charity.

Wouldn't you prefer, if you could, to live for longer free of Alzheimer's?