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New Blood Test Offers Early Warning for Alzheimer's Onset

timothy posted about 6 months ago | from the sure-you-want-to-know? dept.

Biotech 86

Georgetown researcher (and executive dean of Georgetown's medical school) Howard Federoff has taken a "systems" approach to diagnostics for certain chronic diseases. By comparing blood samples taken from patients who subsequently developed Alzheimer's to blood samples after the disease has manifested, Federoff has identified markers and created a blood test that is described as "90 percent accurate" (the BBC article does not delve into the ratio of false positives to false negatives) in predicting whether a currently healthy patient is likely to develop Alzheimer's in the following three years. Understandably, this raises some ethical and practical questions. What would you do differently if this test came back positive for yourself? Or for a parent? Here's the (paywalled) paper, at Nature Medicine.

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First Post (-1)

Anonymous Coward | about 6 months ago | (#46441725)

Claimed for apk, patron saint of trolling.

Re:First Post (-1)

Anonymous Coward | about 6 months ago | (#46441769)

Kind of ironic considering apk only started formulating his hostfile religion after his Alzheimer's diagnosis 15 years ago.

I, for one, do welcome that test (1)

Taco Cowboy (5327) | about 6 months ago | (#46442585)

While I do understand the ethical dilemma as outlined in TFA regarding the blood test for screening the Alzheimer's disease, I do welcome it.

My reasoning is that if I take that test and it comes out positive (that is, there's a great chance I gonna get hit with it, in coming years / decades) it would at least give me more time to be better prepared.

I can put in my will, before my Alzheimer's disease set in, that any other will that I do, after I'm hit with the Alzheimer's disease must be deemed not valid, for people around me could take advantage of my losing of cognitive ability and change my wish on how I want to allocate what I have left to whom I want to leave it with.

I can also take better care of myself, in terms of cognitive health. Maybe I'll put more time in "brain exercise", or taking less food that may be contaminated with substances that have shown to be related to the Alzheimer's disease, such as Aluminium.

Re:I, for one, do welcome that test (1)

polymath69 (94161) | about 6 months ago | (#46442829)

You see the ethical dilemma? I don't see one in either TFA, only a question of whether a person would wish to have this information. So long as the person in question is the patient or his doctor, there's no ethical question at hand, merely a personal decision. Could you kindly explain the dilemma to my obviously symptomatic brain? And type slowly.

Damn beta? Damn this version, I hit "options" and my comment was wiped out. Bastages.

Re:I, for one, do welcome that test (1)

symbolset (646467) | about 6 months ago | (#46443065)

I feel for you. You should see what it's like having to reject the mobile version horror all day. If you liked this article you should read that one about the new blood test that can predict Alzheimer's.

Re:I, for one, do welcome that test (1)

ColdWetDog (752185) | about 6 months ago | (#46443361)

Actually good advice whether or not you're 'planning' on coming down with Alzheimers. You just don't know what the future plans for you. You could live to 90 with multiple high risk alleles for Alzheimers, you could be totally paralyzed, turned into a vegetable tomorrow after the drunk down the street plows into you.

Keeping your brain active (quit posting here), keeping your body active are good things to do no matter what your genetics or past history stay.

Oh, and people who worry about these sorts of things and continue to smoke should just give up. Now.

Re:I, for one, do welcome that test (0)

Anonymous Coward | about 6 months ago | (#46444507)

Are you telling people to quit smoking or give up on life?

Re: I, for one, do welcome that test (1)

romons (2767081) | about 6 months ago | (#46451713)

FYI, no link between aluminum and alzheimer, despite lots of research.

Re: I, for one, do welcome that test (1)

Barryke (772876) | about 6 months ago | (#46453417)

/ puts off aluminium hat
/ stares at ceiling
/ puts on aluminium hat

As a neurologist. (5, Informative)

MPAB (1074440) | about 6 months ago | (#46441771)

The main symptom that brings people to the neurologist is forgetfulness. Most of the time it's subjective (ie. I know someone with Alzheimer's and I begin to notice and worry about the times I meet people and the names won't come to my head). We look for signs of cognitive impairment, with tests that include memory and other mind processes. Of course, YMMV depending on your previous performance, career, educational level, etc.
Once we get proof of MCI, we can make some tests because Alzheimer's isn't the only thing that can cause it. The usual stuff ranges from depression or unfelt strokes to syphillis. The CAT scan/MRI only tells us if the brain is intact, somewhat like trying to work out if a car works by just opening the hood.
Alzheimer's itself can only be diagnosed under the microscope right now. Not a thing we'd agree to to do a live brain.
Other than this blood test, there are radioactive tracer tests and CSF tests. In all of them the result is a chance or ratio telling the possibility of the MCI to be a sign of Alzheimer's against something else.
So, it's a disease for which there is no prevention nor a cure and the current tests just tell us "yes your worries about that time you left the keys on the toilet are related to a 75% propability of having Alzheimer's". We should get into positive and negative predictive values here.
As I tell my patients: "No: there is no sign of cognitive impairment right now. If I knew you were to develop a demence, I'd suggest you settle your pending issues right away, but I don't see a reason not to do that, anyway, You don't know what awaits you at the turn of the corner."

Re:As a neurologist. (-1)

viperidaenz (2515578) | about 6 months ago | (#46441829)

I hope you use the word probability and not propability when talking to your patients.

Re:As a neurologist. (2)

tsotha (720379) | about 6 months ago | (#46441881)

He can get away with "propability" as long as he's not writing.

Re:As a neurologist. (4, Informative)

ljw1004 (764174) | about 6 months ago | (#46442269)

So, it's a disease for which there is no prevention nor a cure

But there are some candidates in Phase 3 clinical trials at the moment, which all will work best if they can have an early diagnosis. I think that's why news of diagnostics tests is good. If any of these candidates pass their phase3 trials, they'd probably be on the market in 2017 - 2018.

* Solanezumab [datamonitor.com] from Lilly
* BACE1 inhibitor [alzforum.org] from Merck
* LMTX [alzheimersstudies.com] from TauRx

Disclaimer: I have family working on LMTX.

Re:As a neurologist. (4, Insightful)

pepty (1976012) | about 6 months ago | (#46442741)

Alzheimer's has been a multi billion dollar graveyard for Pharma over the past ten years - and Solanezumab isn't looking too healthy. Best of luck to Merck and TauRx.

Re:As a neurologist. (2)

Wycliffe (116160) | about 6 months ago | (#46444401)

Alzheimer's has been a multi billion dollar graveyard for Pharma over the past ten years - and Solanezumab isn't looking too healthy. Best of luck to Merck and TauRx.

I think the issue is that they are trying to solve a complex aging issue with a pill. It's like being able to solve old age with a pill.
There are certain things that can help. Taking an aspirin can reduce the chance of a heart attack and a different pill might lower
blood pressure but you aren't going to find a single pill to cure heart disease either. Until we figure out a way to eliminate the
signs of aging and the way the body starts to break down, most of these "cures" are nothing more than stopgaps. Then again,
if the average person only has alzheimers for the last 20 years of their life maybe a stopgap is all we need.

Re:As a neurologist. (1)

pepty (1976012) | about 6 months ago | (#46447607)

It's worse than that: by the time things like Alzheimer's or cardiovascular disease are symptomatic a lot of damage has already been done. To prevent the damage you may have to start treating a decade or more in advance of any symptoms, since healing the damage will only be partial at best. To develop a therapy and determine its efficacy means running clinical trials over a decade or more, something no Pharma wants to face. You can improve the situation a lot via biomarker tests - or just complicate it further. If the tests accurately determine who is at risk and accurately chart their progression into the disease then the trials can be much smaller and potentially much shorter. But if the tests are so-so then approving a therapy based on its ability to change the levels on a biomarker test (as opposed to waiting 5-10 years more to see if it actually changes the levels of Alzheimer's) could be an incredibly expensive and horrific mistake. The antibody based therapies could easily cost $10k or more per year and would need to be taken til death.

To compare the situation to aspirin: giving daily aspirin to people at lower risks of CVD increases their chances of serious/fatal brain bleeds and GI tract bleeds about as much as it decreases their risks of a big CVD event. Now imagine that baby aspirin cost $30 each.

Re:As a neurologist. (0)

Anonymous Coward | about 6 months ago | (#46443671)

I think you confuse 'Disclaimer' with 'Full Disclosure'.

Re:As a neurologist. (0)

Anonymous Coward | about 6 months ago | (#46444335)

This test will give you reading for three markers that show a correlation to cognitive decline. 90% accurate is useless as screening technique the false positives would be thousands of times the real positives and the false negatives are still significant. Even a 100% accurate test would be useless at the moment because we have no preventative treatments and only questionable treatments for symptoms once they appear.

As far as Amyloid B goes there have been drugs that successfully block or even dissolve plaques and tangles that passed drug trials but have been shown to have no clinical benefit. This fits with the picture emerging regarding protein misfolding diseases, where the misfolding protein disrupts cell function (possibly by upsetting gene expression) and the misfold folded protein that accumulates which we notice is a just a side effect so treating that is pointless. There is no reason to expect that similar drugs that have so far shown inclusive trial results will be useful even if the drug companies manage to find some way to get them through trials (which they specialise in) so they can profit from them. Drug companies will of course chase the billions spent on them hoping to get lucky.

According to this theory if LMTX slows plaque formation by stopping tau crosslinking tangles that too would have no effect. Though they could get lucky and find that it works in another way. There was a mouse model study published recently that showed that misfolded tau can initiate cognitive decline and be transmitted from neuron to neuron and produce a progression like AD. This is not proof of a cause of AD, even in mouse models let alone humans but at least its another line of research instead of plugging away at the same old lines where 30 years of research has produced nothing useful.

The thing is humans are designed with planned obsolescence, after 35 it's all downhill. Evolution not only doesn't care what happens to you after your grandchildren are established, in fact it often prefers that you are not in the way. Dr Bryan James argues that AD is 6 times more common than believed because the progression can be slow and a lot of people die of other causes before AD is consider their major medical problem. When looking at TDP-43 misfolding in ALS they thought they had found a simple cause. But then it turned out that 2/3 of the healthy control brains of people aged over 65 have misfolded TDP-43 in the limbic region of the brain that caused no medically diagnosed condition. It's when you get a more wide spread distribution of misfolded TDP-43 in the brain that you die from ALS as your motor neurons fail.

Re:As a neurologist. (1)

Curunir_wolf (588405) | about 6 months ago | (#46445403)

90% accurate is useless as screening technique the false positives would be thousands of times the real positives and the false negatives are still significant.

Not a problem for the drug companies, that's exactly what they want. It's certainly not a problem with HPV screening, which has a 15% false-positive rate. But that's great for doctors, because then they can do the more invasive procedure "just to make sure".

Re:As a neurologist. (1)

blackraven14250 (902843) | about 6 months ago | (#46451703)

Not just that, but I'd wager that a blood test is way cheaper than being scheduled for an MRI. Plus if you have 3 tests, and they all come back high probability, your confidence in the diagnosis is increased.

Knowing could be Useful (4, Interesting)

Roger W Moore (538166) | about 6 months ago | (#46443439)

If I knew you were to develop a demence, I'd suggest you settle your pending issues right away, but I don't see a reason not to do that, anyway, You don't know what awaits you at the turn of the corner.

It's not so much "pending issues" I'd want to settle it's more a case of holidays. Having had a father who died of alzheimer's last year my mum was trapped at home with him for several years and got very few trips away. If my dad had known that he was going to develop the disease in a few years then they would likely have taken more holidays, visited family etc. a lot more because there was a limited window to do so. As it was it was about a one year window from diagnosis to my dad being too confused to travel.

This is not the sort of thing that you would do without knowing knowing that you were developing alzheimer's since, if you took all that travel at once, you'd be stuck at home for several years afterwards. So if there is still no cure when I get to the age to worry about alzheimer's I would certainly find a 3 year advance warning useful - it gives you time to visit the family and travel while you know what you are doing. It's also easier to put your affairs in order before you start to suffer from the symptoms since financial matters are hard enough to get right with your full mental faculties.

Re:Knowing could be Useful (1)

s.t.a.l.k.e.r._loner (2591761) | about 6 months ago | (#46452863)

See "Final Exit" method. As for knowing, though, you may be disappointed. Brain disorders are fascinating and terrifying. When reality doesn't make sense to your brain because of physical errors in processing, your brain simply confabulates whatever details it needs so that things do make sense internally. These confabulations are not amenable to outside reasoning or exposure to evidence that contradicts them. This is equally true with dementia disorders such as Alzheimers as it is with brain damage from trauma/stroke or psychotic disorders. What I'm getting at is that if you are afflicted, you may not retain the level of insight necessary to intervene on your own behalf: you might not be capable of understanding there's a problem.

Re:Knowing could be Useful (1)

Roger W Moore (538166) | about 5 months ago | (#46462757)

You are completely missing the point. That's why I would want the blood test. It tells you that you will develop the disease BEFORE you have symptoms so you have several years to go travelling and visit family before your brain starts to shut down.

Re: As a neurologist. (1)

Xman73x (1032330) | about 6 months ago | (#46446457)

It's creepy because my moms side of the family had that in her back ground history. I hope I never get that disease, but I worry about my mom and my Godfather. My mom was born in Germany ages ago but that's another story. I'm hoping by the time I'm in my 50's they will have a cure for just about everything when it comes down to allergies and Cancer illnesses you name it. I don't like seeing people suffer from these problems.

Re:As a neurologist. (1)

Udom (978789) | about 6 months ago | (#46447537)

The approach locks understanding of alzheimers to body chemistry and that's certainly one component, but there are other elements that go unaddressed. In western nuclear families children grow up and move elsewhere and the elderly often end up living alone. Exclusion and isolation are painful and severe punishments, particularly for women. Elderly women typically fret constantly about their sons, daughters and grandchildren, whom they are lucky to see once a month. In this position little else seems important, and that which is unimportant is deleted from memory. Knitting classes, Bridge clubs and TV are wholly inadequate substitutes... Drug companies would have us believe that the answer to all problems is a drug, and the tunnel vision that produces blinds us to other important causes of the condition.

What would I do? (0)

the eric conspiracy (20178) | about 6 months ago | (#46441775)

Work to protect my assets from Medicaid.

"my assets" (0)

Anonymous Coward | about 6 months ago | (#46441797)

Hasn't human civilisation grown out of the idea of private property? It seems so primitive and religious.

Re:"my assets" (0)

Anonymous Coward | about 6 months ago | (#46441813)

Then you wouldn't mind if I "borrowed" a few things from you...

Correct. (0)

Anonymous Coward | about 6 months ago | (#46441893)

Of course not. I let everyone around me use whatever they want. The only rule is that they take care of it as they would anything they consider their own. I've had this philosophy since mid-20s, I'm early 30s now, and I think it's been abused perhaps once? A couple of times when I have several of something, I let other people borrow my excess and they're overdue giving it back, as who cares? I already have enough. The thousand other times i've made known my "my stuff is your stuff" policy, things have gone quite smoothly.

Really, personal property is an entirely human creation, making people covetous and selfish. Once you stop even thinking in terms of it, and instead in terms of resources around you which are shared responsibly, there is no problem.

Re:Correct. (1)

fractoid (1076465) | about 6 months ago | (#46443947)

If something isn't your private property then you forfeit the right to dictate how it is used. So I could take stuff you've worked hard for, and break it, and you have no right to be upset because it isn't yours.

Re:Correct. (1)

Xaedalus (1192463) | about 6 months ago | (#46446589)

Would you? Would YOU truly do that, if someone trusted you enough to give you stuff that they worked hard for, under the conditions that you care for it and give it back when you're done? Would YOU, Fractoid, be that person to breach that trust?

Re:Correct. (1)

fractoid (1076465) | about 6 months ago | (#46451009)

Notice that you're still "giving" stuff, with conditions. Without the idea of private property, you can't give things because you can't own things. And you can't apply conditions, for the same reason. So no, I wouldn't breach that trust, because there would be no gift and nothing for the trust to apply to. It would not exist to be breached.

Re:"my assets" (1)

tsotha (720379) | about 6 months ago | (#46441885)

No. Alternatives have been tried and found to be monumentally disastrous.

Incorrect. (0)

Anonymous Coward | about 6 months ago | (#46441933)

You're a Eurocentric dullard. Several civilisations have had dominant concept of communal property, and every civilisation has limited concepts of communal property: air, grazing ground, sea, health service, roads, etc.

You're probably thinking of state capitalism, which propelled the Soviet Union forward in two decades to a status which the US required 150 years to achieve. It was inhumane, but it was not disastrous... and by the '30s it certainly didn't reject the concept of private property: it's just that all property belonged to Government inc., and fuck you if you disagreed with what it did with it.

Re:Incorrect. (1)

tsotha (720379) | about 6 months ago | (#46449919)

Several civilisations have had dominant concept of communal property, and every civilisation has limited concepts of communal property: air, grazing ground, sea, health service, roads, etc.

Sure, but the idea there would be no private property just doesn't work. Even the Soviet Union backed of of that piece of silliness within a year or two, if not de jure then de facto.

And sure, there have been civilizations with a "dominant concept of communal property". Failed civilizations.

Re: What would I do? (2)

kayaker01 (3569597) | about 6 months ago | (#46441875)

Format a few drives.

Re:What would I do? (4, Interesting)

akozakie (633875) | about 6 months ago | (#46442503)

Heh... Easy question, unfortunately.

Top priority: prepare an easy and painless way out. Guns are illegal here, so it would take a bit of thinking, organizing, saving money, etc. Probably the best solution would be an international trip to a clinic that will help me, but I would need a backup plan if someone decided to stop me. Better do it early and be ready for later, with a plan simple enough to execute when the illness already has a significant effect (but before it makes me forget I have that option). Later I may not be able to do this and noone will help me. Hell, I wouldn't even ask for it, I don't want that helpful person to go to jail.

Oh, I could have other priorities, if I could achieve this just by making my wish clear. But as long as euthanasia is not legal here, I'd have to rely on myself, so waiting too long would be risky. I will not reach the final, infant-like stages if I can help it. I prefer to keep my dignity, thank you.

So, this is the most important thing. Number two is obvious too - research into current best practices and applying them (diet, activity, training, whatever). Even if it buys me just a few more months of mostly normal life, it's worth it.

Not to suggest that anyone should do the same. If your views or priorities are different, feel free to do whatever you want.

Re:What would I do? (2)

Ol Olsoc (1175323) | about 6 months ago | (#46442565)

Heh... Easy question, unfortunately.

Top priority: prepare an easy and painless way out.

My familiy is under orders to put me on a jet to Alaska, and from there, a bush plane to as far north as possible, and deliver me to Inuits, with instructions to set me out in the weather as senilicide. For that, I'll make a sizable contribution to the village.

Only an hour or so at -20, and I'll be polar bear food.

Re:What would I do? (2)

ColdWetDog (752185) | about 6 months ago | (#46443367)

You'll probably end up getting rolled in Anchorage and get stuck at the Motel 6.

That would be a horrible way to go.

Re:What would I do? (1)

Ol Olsoc (1175323) | about 6 months ago | (#46445695)

You'll probably end up getting rolled in Anchorage and get stuck at the Motel 6.

That would be a horrible way to go.

As compared to most of my relatives, catheterized and on anti-Psychotics, bedridden and bedsores? Wearing diapers so they can shit themselves with impunity. Not knowing who they were, if they were lucky, their skin peeiling off? One took 10 years to die that way.

The good news is the nursing homes took pretty much every cent they had, so the will recipients didn't have anything to fight over. Yeah, that's so much better than freezing to death in a couple hours.

Re:What would I do? (1)

Xaedalus (1192463) | about 6 months ago | (#46446611)

Agree completely. When it's my time, I'm taking the long walk. I will meet my maker, or oblivion, under a starry winter night sky far from civilization. That's how I want to go.

Re:What would I do? (1)

Ol Olsoc (1175323) | about 6 months ago | (#46451285)

Agree completely. When it's my time, I'm taking the long walk. I will meet my maker, or oblivion, under a starry winter night sky far from civilization. That's how I want to go.

And really, that is so much better. None of us gets out of here alive, and the concept of fighting in agony to spend that last few seconds is incredibly masochistic.

Anyone thinking this is so awful, simply needs to compare your rather poetic description of an end to life, to the long, and morally bankrupt forced "life" in the Terri Schiavo case. Forcing bodily functions on a corpse that long ago had her brain converted to cerebrospinal fluid is something that an evil doctor in a horror film might do.

Re:What would I do? (0)

Anonymous Coward | about 6 months ago | (#46444243)

Probably the best solution would be an international trip to a clinic that will help me, but I would need a backup plan if someone decided to stop me.

Nitrogen Asphyxiation [gistprobono.org] is what you're looking for. It exploits a stupid bug in our physiology: the urge to breathe is caused by a buildup of carbon dioxide in the lungs, *not* due to a lack of oxygen.

If you breathe pure nitrogen you will feel just fine until you suddenly black out from hypoxia. Naturally, if one continues to breathe this then death will soon follow.

This is better than carbon monoxide, because nitrogen is completely inert and doesn't leave a hazardous scene for those who are present/recovering your corpse.

Re:What would I do? (2)

Wycliffe (116160) | about 6 months ago | (#46444431)

This is better than carbon monoxide, because nitrogen is completely inert and doesn't leave a hazardous scene for those who are present/recovering your corpse.

Wouldn't a room full of pure nitrogen be just as dangerous to the person recovering you if they also will continue to breath normally
until they black out and die as well?

Re:What would I do? (0)

Anonymous Coward | about 6 months ago | (#46446437)

Good question, but that's not how you would use it. The room air is already 78 nitrogen, so you simply ensure that you breathe the nitrogen via a mask. Add some simple ventilation of the room for peace of mind.

Contrast that with carbon monoxide, which is toxic (as well as being tasteless and odorless). CO binds the oxygen carrying hemoglobin in your blood 200x better than oxygen does. That means even a small amount being breathed is a problem. Similarly, cyanide vapors are highly toxic and persistent once they are in an environment.

Re:What would I do? (1)

Wycliffe (116160) | about 6 months ago | (#46444479)

Top priority: prepare an easy and painless way out. ... Better do it early and be ready for later, with a plan simple enough to execute when the illness already has a significant effect (but before it makes me forget I have that option).

It would take a little bit of thinking but the best solution if you really wanted to do this would be some sort
of dead man's switch that exploited your forgetfulness. i.e. a drawer that explodes if you open it. A
bottle of soda in the fridge that is poisonous, etc... You could easily have multiple booby traps in your
house rigged to go off if you forget they are there. As long as you were of sound mind, you would know
not to trigger them but how to do this safely without accidently endangering a caretaker would be the tricky
part.

Another early marker for the disease (1)

JoeyRox (2711699) | about 6 months ago | (#46441803)

Is if you forget to go to your appointment to take this blood test.

What I tell my wife about the garbage cans (1)

Latent Heat (558884) | about 6 months ago | (#46442297)

If I back the car down the drive and hit the garbage cans, that is not cause for neurological concern

If I hit the garbage cans and not know why this is a problem, it is time for one of these tests.

Re:Another early marker for the disease (0)

Anonymous Coward | about 6 months ago | (#46442663)

Forgetting why reading /. was a way to remember where the car was parked.

Re:Another early marker for the disease (1)

fractoid (1076465) | about 6 months ago | (#46443951)

What test was that?

The "false positives" thing really does matter (2)

Dr. Spork (142693) | about 6 months ago | (#46441817)

If the test is 90% accurate and then has 10% false positives, then one out of ten people who fail the test is actually free of Alzheimer's. But if only 5% of the general population actually develop Alzheimer's, then even if you fail the test, you are still most probably (67%) in the clear. Granted, it's a reason for concern, because your odds of being in the clear dropped from 95% to 67%, but it's certainly not as big an update of your odds as you might have expected from a 90% accurate test that you just failed. (Right? Or did I screw up the math?)

Re:The "false positives" thing really does matter (1)

viperidaenz (2515578) | about 6 months ago | (#46441855)

Apparently there is a big difference between 99% and 99.9%
http://idle.slashdot.org/story... [slashdot.org]
I'm sure it gets even bigger when you're down to 90%

Re:The "false positives" thing really does matter (1)

Jmc23 (2353706) | about 6 months ago | (#46441863)

You even sporked the words up!

Re:The "false positives" thing really does matter (1)

CastrTroy (595695) | about 6 months ago | (#46441979)

Its hard to say if 90% really means 10% false positive rate. It might mean 0% false positive but that 10% of people who will get Alzheimer's will not show up positive on the test. Think about pregnancy tests. If it shows positive, you most likely are. If it's negative, there's chance you might still be pregnant.

Re:The "false positives" thing really does matter (2)

raynet (51803) | about 6 months ago | (#46442037)

Think about pregnancy tests. If it shows positive, you most likely are. If it's negative, there's chance you might still be pregnant.

And your example is of a test that has false positives and false negatives.

The OP is right in that the 90% accuracy is not very useful until we know how common Alzheimer's is in the population taking the test

Good example of this was 99% accurate HIV test if it is applied to random sampling of all people. As HIV is so rare, if 100.000 people take the test, it will flag 1.000 as having HIV even when don't and correctly identify 10 real HIV cases and miss 1. (numbers pulled from memory and probably not accurate)

Re:The "false positives" thing really does matter (1)

pepty (1976012) | about 6 months ago | (#46442721)

In the sample 10% (53 out of 525) had or developed Alzheimers or other cognitive impairments within 5 years.

Re:The "false positives" thing really does matter (1)

raynet (51803) | about 6 months ago | (#46443913)

So that means 90% accurate tests will correctly identify 425 non-Alzheimers cases, miss 5 cases, detect 48 Alzheimers cases and give out 47 false-positives. So in this case when the test flags you, there is 50% chance that you are false-positive.

Re:The "false positives" thing really does matter (0)

Anonymous Coward | about 6 months ago | (#46442135)

A quick skim seems to indicate that they only established a rough false positive rate. It does not seem to be quite there to establish the false negative probabilities. This seems to be because they tested a bunch of different possible tests to see what might be useful for a more thorough study in the future.

Re:The "false positives" thing really does matter (1)

pepty (1976012) | about 6 months ago | (#46442703)

They used mass spectrometry to analyse the blood plasma of 53 participants with mild cognitive impairment or Alzheimer’s disease, including 18 who developed symptoms during the study, and 53 who remained cognitively healthy. They found ten phospholipids that were present at consistently lower levels in the blood of most people who had, or went on to develop, cognitive impairment. The team validated the results in a set of 41 further participants.

I think they will need to look at a much bigger sample before calculated odds will be meaningful. Also, the test may well lose its predictive power if applied to the general population as opposed to people over 70.

why the GOP can't win! (1)

Joe_Dragon (2206452) | about 6 months ago | (#46441841)

As this is just more way to get the pre existing condition black list and job based health insurance is slowly fading away as well.

The ACA did kill off the junk plans that some jobs used to offer that did not cover anything any ways.

And a good predictor then of suicidal tendancies (0)

Anonymous Coward | about 6 months ago | (#46441847)

Because if you gotz to go mad, do it in a flaming blaze of glory!

Why FP/FN? (0)

Anonymous Coward | about 6 months ago | (#46441987)

Why the ratio of false positives to false negatives? Wouldn't precision/recall be more informative?

If it were me (4, Interesting)

transporter_ii (986545) | about 6 months ago | (#46442023)

I would change my diet very quickly and take up jogging:

Is Alzheimer’s Type 3 Diabetes?
http://opinionator.blogs.nytim... [nytimes.com]

Also, I would look specifically at anti-inflammatory diets, because Alzheimers, like many chronic modern diseases, is linked to chronic inflammation (in this case, in the brain):

> Since the late 1980s, various studies have found hints that the chronic inflammation found in Alzheimer’s hastens the disease process

See the connection?

http://www.webmd.com/diabetes/... [webmd.com]

Inactivity and obesity increase the risk for diabetes, but exactly how is unclear. Recent research suggests that inflammation inside the body plays a role in the development of type 2 diabetes.

The good news: An "anti-inflammatory" diet and exercise plan can help prevent and treat type 2 diabetes.

The effects of inflammation are familiar to anyone who has experienced a bug bite, rash, skin infection, or ankle sprain. In those situations, you will see swelling in the affected area.

With type 2 diabetes, inflammation is internal.

Re:If it were me (1)

LaZZaR (216092) | about 6 months ago | (#46442143)

I second everything mentioned above, and also recommend the book "Grain Brain" (look it up on Amazon). It is written by a neurosurgeon who makes a very compelling, leading edge (and medically unpopular) case against grains and gluten, its relationship to inflammation and its effects on Alzheimer's, and the uncanny links with other first world epidemics like diabetes, obesity, heart disease, etc. Its very easy to read and there is lots of research referenced throughout.

At 33 I recently went through a cardiac event, scary as it is at this age, and I am definitely not what you would call morbidly obese. This book will change your thinking and your habits A LOT.

Re:If it were me (3, Informative)

flyingsquid (813711) | about 6 months ago | (#46442559)

Diet can have a profound effect on brain health. One example of this is epilepsy. It turns out that fasting can reduce epileptic seizures- in fact this was originally documented by the Greek physician Hippocrates, in the 5th century BC- but obviously that's not a viable long-term treatment, since eventually you have to eat or you starve. However, it's possible to mimic the state of fasting if you cut your carbohydrate consumption- the body burns fat, instead of sugar, just as it does in a fast. Using low carbohydrate diets- either a fat-heavy ketogenic diet or the induction phase of the Atkins diet- it's possible to reduce seizure frequency in most people with epilepsy. Often it's effective where drugs fail, and a small percentage of people- around 15% actually see seizures eliminated, sometimes permanently, even after they discontinue the diet. In other words, in a small number of patients, diet can actually cure a severe neurological disease like epilepsy.

A few years ago some psychiatrists speculated that it might work for bipolar disorder as well. The thing is, drugs that work for epilepsy also work for bipolar, suggesting they are somehow related. This was purely speculation at the time, but there are now a couple of documented cases of people suffering from bipolar who have been successfully treated with low-carbohydrate diets- and they claim it works better than the drugs.

The implications are profound. Some psychiatric and neurological disorders may in fact be metabolic disorders, perhaps in part caused by diet. There's been a big push in the past few decades to focus on DNA as the answer to everything, but there's a huge environmental component to these disorders. Twin studies show that if one twin has epilepsy, the odds of the other getting it are only around 50%. So even with identical DNA, and being raised in a similar environment, they only have about a fifty-fifty chance of getting the disorder... clearly genetics aren't destiny. What we really need is a better understanding of the environmental effects that cause one person to get a neurological disease, while the another stays healthy. Throwing drugs with severe side effects at people after they get sick is a good business model for pharmaceutical manufacturers, but what we really need to do is prevent people from getting these disorders in the first place.

Last, the observation that low-carbohydrate diets can be effective in treating severe neurological and psyhicatric diseases... well, it has disturbing implications for modern, high-carbohydrate diets.

Re:If it were me (1)

Anonymous Coward | about 6 months ago | (#46444593)

My grandfather (born in 1909) was the healthiest man I have ever known. He was a fitness and health enthusiast. He always ate healthy foods and was extremely active. He developed Alzheimer's at age 75. His mother had dementia (probably Alzheimers). My mother is now showing signs. Genetics seems like a more of a factor.

Rather "What would the government do?" (0)

Anonymous Coward | about 6 months ago | (#46442057)

What would I do? I don't know, I haven't gotten to that point.
What would the government do? Take away my human rights.

Does the ACA open up my records to government snooping?

Re:Rather "What would the government do?" (1)

dalias (1978986) | about 6 months ago | (#46442635)

No, and the ACA eliminates the primary motive for snooping on your medical records: denying you coverage.

Re:Rather "What would the government do?" (1)

Curunir_wolf (588405) | about 6 months ago | (#46445815)

No, and the ACA eliminates the primary motive for snooping on your medical records: denying you coverage.

You'll still get denied coverage if the treatment hasn't been through years of trials and millions of dollars to obtain the "blessing" of the funded-by-pharmaceutical-companies-FDA. That's pretty much always been the case, but now under the ADA it will have to go through a cost-benefit analysis by a board of bureaucrats that may decide it's too expensive, like the NIH does now.

Plus, the ACA by-passes the HIPAA rules that protect your medical records in a number of ways, including supplying access to at least 16 federal bureaucracies by default, ostensibly to ensure you are "complying" with their mandates.

Coffee (2)

dalias (1978986) | about 6 months ago | (#46442227)

Increase my coffee intake from 1-3 cups per day to 10+ cups per day: http://www.ncbi.nlm.nih.gov/pu... [nih.gov]

Re:Coffee (2)

sinij (911942) | about 6 months ago | (#46442957)

IAmTryingThisDietRightNowButWhyIAmHereAgain?!
 
*Furiously shuffles away with his walker*

seriously? (0)

slashmydots (2189826) | about 6 months ago | (#46442277)

Oh wow, what a useful breakthrough...considering there's no cure or prevention.

Re:seriously? (1)

dalias (1978986) | about 6 months ago | (#46442643)

There is: see my post just above.

what would i do differently? (0)

Anonymous Coward | about 6 months ago | (#46442287)

i would behave like an animal and feign ignorance until the alzheimers kicked in :)

Finalize my will.... (1)

mark-t (151149) | about 6 months ago | (#46442453)

... with the stipulation that it cannot be further modified by me at any time after I have been diagnosed as having such dementia.

little known fact (0)

Anonymous Coward | about 6 months ago | (#46442501)

when he was a grad student , HF owned a cosworth vega - thats right, Chevy air shipped vega bodys to england,where cosworth put screaming hot engines in em

I'd avoid the temptation to forget about it... (1)

sonamchauhan (587356) | about 6 months ago | (#46442665)

Now that I have your attention with my crude joke*, here's the real tip -- coconut oil. virgin. cold pressed.

Greenie article:
http://undergroundhealthreport... [undergroun...porter.com]

Clinical trial:
http://health.usf.edu/NR/rdonl... [usf.edu]

(*My get out of jail card - a family history of dementia)

What would I do? (1)

MillionthMonkey (240664) | about 6 months ago | (#46443181)

I would volunteer for that one-way mission to Mars!

Of course the trip better not take too long, because of the Alzheimer's progression. If I get there too late, I might make a fool out of myself on the mission:

"Hi, Mars, Bob Flemstein, big fan! I know you're crazy busy with us suicidal visitors and everything, but...could you sign? I don't wanna be that guy, but..."

Re:What would I do? (1)

ColdWetDog (752185) | about 6 months ago | (#46443379)

"Monkey! You left the airlock open again!"

Somehow, it just doesn't strike me as a good idea.

So what? Still a death sentence. (1)

gelfling (6534) | about 6 months ago | (#46444205)

Who wants to know earlier they have a horrible fatal disease? And who wants their insurance company to know that as well?

Alzheimer's assay in 2011 (1)

Guppy (12314) | about 6 months ago | (#46444275)

Professor Bob Nagele (from the med school I'm attending now) has had a blood-based Alzheimer's test since 2011 [webmd.com] : http://www.plosone.org/article... [plosone.org]

Using human protein microarrays to characterize the differential expression of serum autoantibodies in AD and non-demented control (NDC) groups, we identified potential diagnostic biomarkers for AD. The differential significance of each biomarker was evaluated, resulting in the selection of only 10 autoantibody biomarkers that can effectively differentiate AD sera from NDC sera with a sensitivity of 96.0% and specificity of 92.5%.

As for me and mine (0)

Anonymous Coward | about 6 months ago | (#46444549)

Be practical. The first thing I would do is get circumcised. Cleansing this area is very easy to miss and often is missed by hired help. Activate your final arrangements upon diagnosis, not your death. Abdicate control of your life and assets slowly and gently. This is a gentle disease if dealt with gently. However the results can destroy the family while the patient loses control. Prepare while you can then relax and enjoy your friends and family as long as you can.

Tax payer funded research behind a pay wall? (1)

fygment (444210) | about 6 months ago | (#46444731)

From the author's research page [georgetown.edu] : "His research has received support from the National Science Foundation, the National Institutes of Health (NIH), and the U.S. Department of Defense, among other sources." Irritating, no?

We can already do this with a free 10 minute test (1)

WillAffleckUW (858324) | about 6 months ago | (#46447605)

There is a free 10 minute test that was developed at the UW which has a higher accuracy rate and can be administered by any physician.

Without a blood draw.

I guess if you don't pay for it, you don't realize the cheaper one is the better one.

And the reason for using a physician is that they can follow up with treatment after confirming the diagnosis.

I'd kill myself before I lost my sanity. (0)

Anonymous Coward | about 6 months ago | (#46448039)

I hope they refine it, I've seen people in the nursing home I worked at years ago die from it and it was horrifying. To watch them lose everything, forgetting their grandkids, friends, and eventually how to live. To see families visiting, especially with the grandkids was hard to watch because they're usually the first to be forgotten.

Precautions and Home remedies for Alzheimer's (1)

completehealthnews (3577545) | about 5 months ago | (#46481409)

Precautions: Do not consume alcohol, do not smoke.Do not eat tinned food or packaged food.Learn new things; stay busy in writing, reading and other things.Engage yourself in activities. Home remedies: Diet plays a very important role in slowing the progress of an Alzheimer patient [completehealthnews.com] . Almonds, hazelnuts, vegetable oils, egg yolk, whole grain products and avocado are rich sources of Vitamin E, which plays a role of deterrent to Alzheimer.Various Natural Herbs have medicinal properties that can fight Alzheimer. Herbs like Rosemary, Dandelion, Fenugreek, ginkgo, Brazil nut, stinging nettle, willow, gotu kola, fava beans and horse balm have shown excellent results in Alzheimer’s. It has been proved that consuming pumpkin regularly helps fight the disease. So eating pumpkin is recommended.Sesame oil, sesame seeds and sunflower seeds are used for ages to increase the strength of the brain. Eat lots of carrots to improve memory and health [completehealthnews.com] .
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