Diagnosis of Alzheimer's: Ignorance Is Bliss?

Alzheimer's is a mental degenerative disease which, though common, is still not at all well understood. Currently, the leading hypothesis for the cause of Alzheimer's symptoms (memory loss and a progressive inability to care for one's self) is the "amyloid hypothesis" which says that the disease occurs when a toxic protein, beta amyloid, accumulates in the brain. The bulk of drug research has been based on this hypothesis, focusing upon the idea is that if beta amyloid levels are reduced, the disease might be slowed, halted or even prevented if treatment starts early enough.

Many drugs have been developed, however very few have been effective. For example, the "Lilly" drug at first seemed promising, and was among the first shown to breach the blood-brain barrier and reduce levels of beta amyloid in the brain. But while it did slow down amyloid production, it did not have any prolonged effect of reducing symptoms in Alzheimer's patients. In fact, it even proved detrimental to their health because of other side effects that were originally not expected.

The "Lilly" example demonstrates the tension between our current lack of knowledge about the workings of the disease, and our desire to develop drugs in order to alleviate suffering. This tension has been intensified by the improvement in detection technologies, which are able to pick up even slight levels of plaque build up in the brain and allow for accurate predictions of Alzheimer's disease before its full onset later on.

But even though we have these technologies, is there really any benefit to the average individual for getting tested early on for Alzheimer's, if there are still no drugs which can help later? Simply knowing that you will develop Alzheimer's, while there is no available cure, has almost no benefit to the patient - it might simply produce feelings of hopelessness and depression while potentially complicating other aspects of life such insurance and employment. Once the world knows that you are soon doomed for mental incompetency, they will treat you differently.

Right now, the only benefit from this highly sensitive testing is for drug companies and researchers, who will be able to identify test subjects and carry out better trials on patients who do not already have advanced Alzheimer's. Usually, we like to focus upon relieving suffering, and to be aware of our own states of health. But perhaps ethically, in this case it would be better right now to focus upon understanding of the disease rather than finding a cure. Given our current state of knowledge and lack of a cure, perhaps ignorance is bliss for the general population when it comes to Alzheimer's?



http://www.nytimes.com/2010/08/19/health/19alzheimers.html?_r=1&ref=the_vanishing_mind