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September 24, 1997

Genetic Testing for Alzheimer Disease

Author Affiliations

University of Massachusetts—Amherst School of Public Health

JAMA. 1997;278(12):978-979. doi:10.1001/jama.1997.03550120038022

To the Editor.  —I disagree with the conclusion drawn by Dr Post and colleagues1 that genetic testing of asymptomatic individuals at risk for Alzheimer disease (AD) is unwarranted. Alzheimer disease is a prevalent and costly disease with tremendous attendant suffering both for the affected individual and for the family, who must bear the brunt of the inexorable decline in the individual's cognition and social skills.2 The disease also has a protracted prodrome: it may take 30 years or longer for the brain to incur sufficient damage for clinical symptoms to manifest. But once degeneration reaches that critical point, if we follow the "ethical perspective" recommended in the consensus statement, we can hope only to delay or, at best, arrest the disease at the stage at which memory loss and other deficits are apparent.From the vantage point of public health, a disease that manifests over decades offers the