Article On The Affect Of Biomarkers For Alzheimer’s On End-Of-Life Choices

Rebecca Dresser (Professor of Law, Washington University) recently published an article entitled, A fate worse than death? How biomarkers for Alzheimer’s disease could affect end-of-life choices, 12 Ind. Health L. Rev. 651-669 (2015).

For many years, scientists have searched for biological markers of the brain deterioration associated with the cognitive impairments characterizing Alzheimer’s disease (AD). Although the search for useful biomarkers is ongoing, there is increasing evidence that certain brain changes indicate that a person is at relatively high risk of developing full-blown AD. Much of the research on AD biomarkers is motivated by the belief that successful treatment will require very early intervention in the disease process. Unfortunately, by the time people develop the memory and other behavioral problems that are associated with AD, significant brain damage has already occurred. Biomarker tests could give patients and clinicians the opportunity to start drug and other treatments early, with the goal of slowing or stopping the deterioration that can eventually produce the clinical symptoms of AD. We can all hope that the medical promise of AD
biomarkers becomes a reality. But it will take years to determine whether biomarker testing and early intervention produce clear health benefits. Currently available AD treatments are largely ineffective, and early therapeutic intervention remains unproven. Before effective treatment becomes available, many people tested for biomarkers could learn that they are at higher-than average risk of developing AD. Some people will appreciate this early warning, for it will give them an opportunity to get their affairs in order, take a long-desired vacation, and “have the kind of heartfelt talks with their children that that people often put off.”