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Presymptomatic apolipoprotein E genotyping for Alzheimer's disease risk assessment and prevention
Author(s) -
Schipper Hyman M.
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.06.003
Subject(s) - apolipoprotein e , genotyping , dementia , disease , context (archaeology) , epidemiology , alzheimer's disease , psychology , medicine , asymptomatic , gerontology , genotype , genetics , biology , gene , paleontology
Current practice guidelines advocate apolipoprotein E ( APOE ) genotyping in cases of dementia and mild cognitive impairment and also in asymptomatic participants within the context of clinical/epidemiological research. APOE genotyping is not recommended for prognostication in cognitively intact persons outside the research arena. On the basis of emerging developments, in this article, we revisit the notion that presymptomatic APOE testing might be medically appropriate and ethical for the purpose of Alzheimer's disease (AD) risk assessment and prevention. In support of this thesis, recent evidence is adduced indicating that (i) the potency of potentially modifiable AD determinants and responsiveness to intervention may be affected by the presence or absence of the ɛ 4 allele, (ii) disclosure of APOE status to asymptomatic individuals seeking AD risk assessment is well tolerated when appropriate safeguards are in place, and (iii) awareness of personal AD risk in general, and APOE status in particular, may motivate individuals to engage in beneficial, risk‐lowering behaviors.