What Is The Clock Test For Dementia
The clock test is a non-verbal screening tool that may be used as part of the assessment for dementia, Alzheimers, and other neurological problems. The clock test screens for cognitive impairment. The individual being screened is asked to draw a clock with the hour and minute hands pointing to a specific time. Research has shown that six potential errors in the clock testthe wrong time, no hands, missing numbers, number substitutions, repetition, and refusalcould be indicative of dementia.
Is There Anything You Can Do
Unlike glaucoma, diabetes, or some cancers, there is no early detection screening for Alzheimerâs disease. Thereâs no definitive way to prevent it either.
âThereâs just nothing practical or actionable to do with this information,â Weissman says. âItâs not going to change anyoneâs medical management.â
The lifestyle recommendations that might help lower risk for Alzheimerâs, Weissman explains, are the things that doctors encourage their patients to do anyway. Research shows that a healthy diet, plenty of exercise, enough sleep, fewer calories per day or periodic fasting, and brain stimulation can all improve your odds of living out your life dementia-free.
But, 23andMeâs Wu argues, âWe know these are standard recommendations for staying healthy, but we also know that most people donât follow them. Genetic information can be the triggering event that gets people motivated.â
It certainly motivated Julie Gregory of Long Beach, IN, to overhaul her lifestyle. Like Tyrone, she took a genetic test for reasons unrelated to her Alzheimerâs risk. When her 23andMe results revealed that she had two copies of APOEe4, she thought of those âsenior momentsâ sheâd had since she was 49. Sheâd forget the names of people sheâd known for 20 years when she ran into them at the grocery store. Her test results filled her with dread. Were the wheels already in motion on the road to Alzheimerâs disease?
What To Know Before You Test For Alzheimers
Fitness guru Margaret Tew Romero on a hike with her parents Susan and Dr. John Tew.
What about you? Are you thinking about buying a genetic test for Alzheimers disease? Its important to understand a few facts. First, Alzheimers disease is linked to over 25 identifiable gene variants. 23andMe tests only for the ApoE4 gene the one associated with the late-onset Alzheimers disease that afflicts people after the age of 60. Early-onset Alzheimers disease, a devastating form that afflicts multiple family members in their 30s, 40s, and 50s, is linked to a different genetic mutation.
Second, testing positive for the ApoE4 gene does not mean you will definitely be diagnosed with Alzheimers. It doesnt mean you wont get it either if you test negative. ApoE4 is jut one of many genes linked to Alzheimers. Also, we dont know if all cases of Alzheimers are linked to a gene. To make matters even more complicated, there are other types of dementia that are not the same as Alzheimers disease. In fact, blood vessel disease, such as atherosclerotic plaque, is the likely cause of up to 20% of dementia.
Testing for the ApoE4 gene can help calculate your risk of a future diagnosis, however, depending on how many copies you inherited. Those that are heterozygous for ApoE4 have a threefold increased risk of Alzheimers. Those who are homozygous for ApoE4 have a 15-fold increased risk.
Might Genetic Variants Not Picked Up By The Tests Increase Or Decrease My Risk Of Acquiring These Diseases
Definitely. Thats why many expert groups recommend against testing for ApoE4, hemochromatosis, and others. The American College of Medical Genetics warns that because Alzheimers develops in the absence of ApoE4 and because many people with ApoE4 seem to escape disease, it does not recommend testing for the variant.
There Are Many Emotions Involved With Dna Testing Especially For Something As Serious As Dementia
Receiving the news that you carry the gene mutation for FAD or the e4 gene that puts you at higher risk of developing Alzheimer’s can come with a myriad of them. It’s not uncommon to feel fear, particularly when you’re dealing with the unknown.
A DNA result that shows you as an e4 carrier can be frightening, even more so if you’ve seen someone go through the trials of the disease. However, while it’s been stated before, it’s important to know that just because you’re at a greater risk doesn’t mean that you will definitely develop Alzheimer’s.
Rather, take it as a precautionary approach and better prepare for the future.
Similarly, those with a reduced or neutral risk may be elated to receive this news, but it’s noteworthy to mention that they may still develop the disease, so there’s no definitive answer with these types of tests. Take the information and process it as it’s intended, as a soft guide to your genetics.
However, the effects tend to be more psychological and can lead to feeling clinically anxious or depressed. Some may feel regret after taking the test, feeling as though they’re better off not knowing the results, especially since most forms are incurable.
If you do decide to get your DNA tested, consulting with a genetic counselor might help you deal with the ramifications of your results.
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What Will A Genetic Test Actually Tell Me
At most, that you carry a DNA variant that, according to research, is associated with a higher risk of a disease. For the rare clotting disorder hereditary thrombophilia, for instance, the report will say that you do or do not carry a variant called Factor V Leiden in the F5 gene and a variant called Prothrombin G20210A in the F2 gene.
23andMe is still fine-tuning the reports, but its tests will also tell you how the presence of variants affects the risk of getting a disease during your lifetime. If theres enough science to quantify that, the report will specify a percentage, like your risk is 3 percent. If not, it will just say theres an increased risk. Of course, you can also look it up. For Alzheimers, carrying two copies of the ApoE4 variant , as 1 to 2 percent of the population does, raises the lifetime risk of the disease to as much as 87 percent, for instance, compared to about 9 percent in the general population.
Dementia Affects An Estimated 50 Million People Globally With Over 5 Million Of These Cases In The United States Alone
This number is expected to increase exponentially in the next several decades. Currently, there is no cure, but with the proper research and knowledge, you can learn how to handle the prognosis and progression of the disease.
Early detection is the key to making life more comfortable, and while not all cases are genetic or hereditary, DNA testing can help pinpoint markers for specific types of dementia.
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The Simple Answer Is Yes You Can Be Dna Tested For Dementia The Complex Answer Is That While You Ascertain If You’re Carrying Any Of The Related Genes Associated With Alzheimer’s Or Fad It Cannot Provide Much More Information Than That
For example, if your DNA test results show that you have the e4 gene, it’s not certain that you’ll actually develop the disease. Many people who carry it go on to lead perfectly healthy lives well into their senior years. It also cannot tell you what age you might begin displaying the symptoms.
The genes relating to FAD, on the other hand, if present, do indicate that the carrier will develop the disease. FAD is commonly diagnosed in a person’s 40s or 50s and is one of the more common early-onset forms of dementia.
Genetic Testing For Alzheimer’s Has Emotional Risk
August 18, 2020 â Twelve years ago, Jamie Tyrone volunteered to participate in a clinical trial. The researchers wanted to know whether learning your genetic risk for developing some 20 or so different diseases, through a direct-to-consumer genetic test, would prompt you to take up a healthier lifestyle. But Tyrone wanted to get something else out of the study.
The San Diego-based retired nurse, now 59, had been living with mysterious progressive neurological problems for about 15 years. The debilitating weakness and fatigue had pushed her into early retirement. Sometimes she needed a scooter to get around the one-story ranch she and her husband bought to accommodate her increasing physical challenges. But doctors had never made a definitive diagnosis. While brain scans ruled out multiple sclerosis, this clinical trial would tell her if she had a gene that predisposed her to the condition.
So focused on learning her genetic risk for MS, Tyrone didnât give any thought to the other diseases sheâd learn her risk for, including Alzheimerâs disease.
Tyrone had two copies of the e4 variant of the APOE gene — one inherited from her mother and one from her father. Someone who has one copy of e4 may be three times as likely to develop Alzheimerâs disease as someone who doesnât have it. Two copies can make you up to 12 times more likely to develop the disease. Tyrone was devastated.
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Genes And Vascular Dementia
Vascular dementia is caused when blood flow to the brain is reduced, damaging nerve cells. This can happen as a result of a stroke or damage to blood vessels deep in the brain. The majority of cases of vascular dementia are not caused by faulty genes.
We may carry genes that affect our risk of stroke, heart disease or other diseases that may contribute to vascular dementia. However, lifestyle factors such as smoking, lack of exercise, obesity, drinking alcohol over the recommended limits, and an unbalanced diet can also affect our risk.
There are rare genetic disorders that can cause vascular dementia by damaging blood vessels in the brain. One is called CADASIL and can be passed down through families. CADASIL only affects around 1,000 people in the UK.
What Consumers Should Know
Experts say story’s like Fender’s are rare, but are likely to grow as direct-to-consumer genetic testing becomes more popular.
Jill Goldman, a genetic counselor specializing in dementia at the Taub Institute at Columbia University Medical Center, said, “People are going to need help,” she said. “And we are not ready to handle it.”
But Stacey Detweiler, a medical affairs associate at 23andMe, said patients should always bear in mind that the genetic tests are imperfect. “I always think it is important to point out that a 99.9% accuracy can still mean errors,” she said. “Even if every variant included in our chip was validated for an accuracy of 99.9% , that still would mean potential for about 600 errors in the 600,000 variants.”
As Hercher writes, “the number of mistakes can be as high as 600 per customer.”
Different companies also use different algorithms to determine their test results. These algorithms can change based on the size and diversity of a company’s database population.
And even with accurate results, consumers can be confused about their health risks, experts say. For instance, results that say a person has a risk of getting a disease doesn’t mean they will get it. Detweiler said consumers should always consult a physician before taking any action based on their test results.
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Experts Currently Recommend Against Apoe Genetic Testing In Medical Care
According to Langbaum, the Banner Alzheimers Institute generally does not recommend people seek ApoE genetic testing in medical care at this time . For one, she said there are currently no FDA-approved therapies that target people with a genetic disposition to Alzheimers.
Langbaum also noted that Alzheimers can afflict people with or without ApoE4. These are not foolproof tests that tell somebody with 100 percent certainty whether you will or wont develop the disease, she said of genetic tests for ApoE status.
She added, There lots of other things in addition to genetics that influence a persons risk. While age is the greatest non-genetic risk factor, other variables include family history, gender, education and health conditions like diabetes and high blood pressure. Peoples lifestyle such as diet, sleep, exercise and social interaction also influence their risk for developing Alzheimers. Regardless of peoples ApoE status, Langbaum noted that everyone should be living a healthy lifestyle to the best of their ability.
Learning your ApoE results with proper genetic counseling is safe and well-tolerated, Langbaum said. Well see a little increase in anxiety and feelings of stress. After the counseling, that usually dissipates and goes back to normal within six to 12 weeks after the session.
There Are Several Pros And Cons To Getting Your Dna Tested But Ultimately The Choice To Undergo The Test Is 100 Percent Your Decision
If you do decide to get tested, you will at least have an answer to whether you have inherited the genes responsible for the disease. The main downside of getting your DNA tested is that if the results come back positive, you have to live with the fact that your future holds uncertainty.
The pros exist for both negative and positive markers. If the test identifies that you carry the genes associated with dementia, you can begin to make preparations and important decisions such as creating a living will that outlines your desired care plan.
You can also appoint which, if any, family members you want in charge of carrying out your living will. In the long run, you’ll be better prepared than someone who is unaware they’re carrying the genes.
The other positive is that your tests may come back and indicate you’re carrying no markers, which of course, would be welcome news.
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How To Diagnose Alzheimers Vs Dementia
Alzheimers is a progressive and fatal brain disorder. Dementia is not a specific disease, but an umbrella term that defines a syndrome and used to refer to a specific group of symptoms related to a decline in mental ability. Alzheimers is one of the most common causes of dementia. Both Alzheimers and dementia are diagnosed using a variety of different assessments and tests, including a physical exam, lab tests, cognitive and neuropsychological tests, and an analysis of changes in behavior.
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Certain genes like ApoE that play an important role in the disease. ApoEs genetic variant, known as ApoE4, is the strongest genetic risk factor for developing Alzheimers in later life. Genetic tests by mail, like 23andMe and AncestryDNA, make it easy to learn about ones ApoE status and to learn that one may have a much higher likelihood of developing Alzheimers in their lifetime. But just because a person carries the ApoE4 variant doesnt mean that their fate is sealed: Alzheimers is a complicated disease, and genetics is one among many factors, from lifestyle and environmental factors to preexisting health conditions, that influence peoples risk.
Being Patient sat down with Jessica Langbaum, co-director of the Alzheimers Prevention Initiative at the Banner Alzheimers Institute, to discuss the complex role of genetics in Alzheimers, asking: Should people seek genetic testing for Alzheimers? And if they do, how can they ensure they are prepared for what they find?
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New Test Makes It Easy To Learn Your Apoe Status But Should You
Last week, the personal genetics company 23andMe announced that it received FDA approval to offer genetic information for 10 health risks . The 10 new genetic risk reports include one for late-onset Alzheimer’s, the most common form of the disease.
In its late-onset Alzheimer’s report, 23andMe provides people with their APOE gene variant. APOE is associated with varying risk of developing Alzheimer’s, and there are three possible types. APOE3, found in about 70% of the population, is the most common variant and is considered neutral. APOE2 is the rarest form, found in 5-10% of people, and is associated with reduced risk of Alzheimer’s. APOE4, found in 1015% of the population, is associated with a greater risk. Everyone has two copies of the APOE gene: people with E2/E2 have the lowest overall risk for Alzheimer’s and those with E4/E4 have the highest risk. The other combinations of APOEE2/E3, E2/E4, E3/E3 and E3/E4fall in between.
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Genes And Frontotemporal Dementia
Frontotemporal dementia , originally called Picks disease, is a rarer type of dementia mostly affecting people under the age of 65 years. The symptoms of FTD can be quite varied but include changes that mostly affect behaviour or language. There are different types of FTD, and these are likely to have different causes.
Some people with FTD have a family history of dementia and the condition may be inherited in some of these families. For behavioural variant FTD, a third to half of people could have a family history. This figure is thought to be much lower for other types of FTD.
Overall, around one in ten cases of FTD are thought to be caused by a faulty gene passed down in families. Several genes have been found that can cause these inherited types of FTD, including:
Mutations in the MAPT gene can cause the tau protein to behave abnormally, forming toxic clumps that can damage brain cells. We still need to understand more about how mutations in progranulin and C9ORF72 cause the disease.
The C9ORF72 gene can cause people to develop motor neurone disease, FTD or both conditions, and may affect members of the same family differently.
In cases of FTD that are not caused by faulty genes, the risk factors are not yet fully understood, and research is ongoing.
Is genetic testing available for frontotemporal dementia?
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