Genetic Testing for Memory Impairment

Many of my patients think that having a genetic test for Alzheimer's disease will tell them whether they will get the disorder. But it won't—at least not for most people. People with a family history of early-onset familial Alzheimer's disease can learn if they carry one of the genetic markers that convey a 100 percent probability of developing the disease. Inheriting a specific mutation in one of three genes—presenilin 1, presenilin 2, and the amyloid precursor protein gene—means that you will get the disease; not having a mutation means that, despite your family history, your risk is no greater than for a person without the mutation.

There are many ethical and psychological issues to consider before having a genetic test. For patients with a positive family history of early-onset disease, the outcome of the genetic test is definitive. Although they may want to know their genotype for any number of reasons, a positive test is almost always emotionally devastating. If a patient insists on knowing his or her genetic destiny, I make certain that the person consults with a genetic to know your genetic profile, you shouldn't be tested. If you decide to be tested, make sure that you receive counseling both before and afterward so that you understand exactly what the results mean and have the emotional and psychological support you need to cope with them. See the sidebar "Genetic Testing for Memory Impairment" for more information.

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