It is a truth, universally acknowledged, that a senior in possession of a brain, must be in want of a diagnosis.
If you missed the specifics, researchers reported that doing a spinal tap—a lumbar puncture with a needle— and examining the withdrawn fluid for certain proteins can tell who has or will have Alzheimer’s Disease or AD. Enthusiastic commentators fantasized about diagnostic spinal taps becoming as common as mammograms or colonoscopies. Maybe there would be specialty spinal tap clinics. All in all, the media greeted the spinal tap method of obtaining an AD diagnosis as a great step forward.
What got lost in the reporting
Two important things got lost in the headlines and articles—the opinions of consumers and the uncertainly of the spinal tap method.
First, consumers—that’s us—do not want to get spinal taps for any reason, least of all to tell us we are doomed to get a disease for which there is no cure except death.
Also, spinal taps have a risk, persistent headaches being one of them. And, like other medical procedures, they cost, though a consumer will search in vain on the net for their actual cost, so removed are we from the financing of our medical care. But risks and costs are not the biggest objections I hear from readers.
Their reaction can be summed up this way: Are those researchers nuts? Do they think we want to ruin our present lives with worry over a terrible future where we don’t even know our own kids? Do we want to condemn ourselves to Death Row with a spinal tap?
This is the standard answer to those questions: knowing ahead of time about AD gives one the chance to prepare. But I say we should be prepared with wills, medical directives and plans for our old age no matter what. We shouldn’t need predicted disasters to get us off the dime.
The results are not as clear as headlines claim
The second objection: If you actually read the research abstract in the Archives of Neurology—Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People— you will read that not all people clinically diagnosed with AD had the all the AD biomarkers in their spinal fluid. And about 30% of those people who were cognitively normal with no outward sign of AD had the AD biomarkers in their spinal fluid. So there were not perfect match-ups.
Some commentators guess that the apparently normal people with AD markers will go on to get AD, but that’s a guess only time can confirm. Meanwhile, work continues on other methods of diagnosis including PET scans combined with memory tests. But don’t look for a lot of older people lined up to get needles in their spines.
Neglected: Cause and prevention
Truth to tell, it is probably a great help to researchers to have more stable ground, a biomarker spinal fluid test, under their feet, but what I want to know is why the main thrust of research is aimed at a cure. Why not a big push on finding the cause of AD? All things have a cause. What causes AD? And then, how can AD be prevented? But there is profit in selling drugs and procedures once the AD horse is in the brain barn, and prevention is not likely to inflate anybody’s bottom line.
Anyhow, that’s a consumer take on one of the many unfolding AD research stories. Stay tuned because it’s going to go on and on, including the fascinating possibility of a vaccine.