Here at DNAGeek, we’re staying up to date with the latest developments with new DNA tests that hit the market. Our goal is to give you all the information you need to determine which test, if any, is best suited for your needs.
DNAGeek Guide to Alzheimer’s Risk Tests – Quick Overview
Alzheimer’s is a form of dementia and is part of a cluster of age-related diseases as it typically appears after the age of 65, though it may present younger in some patients. As of 2018 statistics, the disease currently affects over 5 million people in the United States and is increasing at an alarming rate with the number of diagnoses expected to increase to nearly 14 million by 2020, which is just one short year away. Currently billed as the sixth leading cause of death in the country, it’s only natural to want to brush up on your knowledge, and even take a DNA test to see if this age-related disease is in your future. Before you decide to take one of these at-home tests, it’s important to learn what it can — and can’t — tell you.
Is There a DNA Test to See If You Have the Alzheimer’s Gene?
Currently, there are a few different ways you can get tested to see if you are a carrier of the Alzheimer’s gene. First is a lab test done at your physician’s request. This happens if you’re concerned about the potential of being a carrier due to increased family risk. It may also be requested if you and the doctor agree that you’ve started exhibiting symptoms. If you’re interested in whether you carry any of the variants, you can also opt for at-home testing through companies like 23andMe, which, as of January 2019, is the only company to offer an FDA-approved for sale kit. This is good news because it means that 23andMe has proved to the FDA that their results are accurate and therefore the consumer can rely on their kits.
Popular Alzheimer’s Genetic Testing Kits
The 23andMe saliva-based test is approved for sale and covers the ApoE gene along with many others in their Health + Ancestry test, which as of January 2019 costs $199. It’s not a comprehensive test by any means, but it does test for the Apoe-e4 variant, which indicates that the user is at a higher risk of developing late-onset Alzheimer’s which occurs past the age of 65. The results will come with an explanation of the disease, an assessment of your risk and the information you need to bring to your physician or genetic counselor should you have more questions.
ADx’s Alzheimer’s genetic test, which also costs $199, gives you a little more insight into the ApoE gene and how it works in your body. It also outlines what happens with your risk, how it increases as you age and how your risk compares to others. With ADx, your test undergoes physician review and you get access to genetic counseling at no added cost if you need it following the receipt of your results. Like 23andMe, ADx determines your risk based on which ApoE variants it detects in your DNA.
The test you choose depends on the type of information you’re looking for. If you want a full health panel, 23andMe is the way to go, but if you’re just looking for more information on the Alzheimer’s-specific gene, then ADx Healthcare fits the bill.
How Do Alzheimer’s DNA Tests Work?
Alzheimer’s DNA tests work much in the same way that other DNA tests work. You take a buccal swab, also known as a cheek swab, or a saliva sample, and seal it in the test tube provided in the kit you receive. Once you mail it back to the facility, they’ll log your kit in the system as received and then you’ll be able to follow its progress.
When your test is evaluated, the technicians will look closely at the ApoE gene to determine which variation you carry. The results will be sent to you in an easy-to-read report that’s free of technical jargon so you can understand the findings.
Other Disease-Related DNA Tests
If you’re looking for more than just Alzheimer’s testing, there are various other DNA tests available for at-home use. Some focus on a single niche such as cardiovascular health, others combine several different diseases in one kit such as Parkinson’s, Celiac Disease and BRCA1 and BRCA2, which test for breast cancer risks. Others can determine your risk for high blood pressure and stroke by evaluating a specific set of genes.
How Accurate Are DNA Tests for Alzheimer’s?
While the DNA tests can accurately identify the ApoE variants, this isn’t the entire story behind your risk factors. For example, if you’re identified to have the ApoE-e4 variant, which indicates a higher risk of developing Alzheimer’s as you age, this doesn’t mean that you will develop it. In the same token, those who don’t carry the variant may still develop late-onset Alzheimer’s so the tests really only give a glimpse into your overall risk. Additionally, there are other mutations that could indicate the increased likelihood of developing Alzheimer’s that these tests don’t look for. These mutations can tell you much more about the disease, including with certainty whether you’re a carrier of Familial Alzheimer’s Disease, or FAD.
If you’re looking for definite answers about inherited Alzheimer’s, including if you’re a carrier for FAD, visiting your doctor and having a prescribed test done is in your best interest.
Does Alzheimer’s Run In Families?
The answer, in short, is it can run in families, but that doesn’t mean if someone in your family has the disease, that you will develop it as well. As a matter of fact, there is only one type of inherited Alzheimer’s: FAD. This is caused by a gene mutation on three different chromosomes: 1, 14 and 21. Your parents, if they carry the markers, have a 50 percent chance of passing down these gene mutations which lead to early-onset Alzheimer’s, which occurs between a person’s 40s and 50s.
Is Alzheimer’s Inherited From the Mother or the Father?
There have been studies done to determine whether the inherited risk is passed down from the maternal or paternal side. A study in 2011 revealed that there is a higher chance that the disease is passed down on the maternal side, and the odds are higher if one of your parents have it.
Should You Be Tested for Alzheimer’s Risk?
This is a very personal choice that you have to make, nobody can make it for you. If there’s a history of the disease in your family, you might be curious to see if you carry the gene mutations of FAD, or if you’re a carrier of the ApoE-e4 variant. However, there are several considerations you want to keep in mind. With the exception of FAD, any other risk factor is not a definitive answer as to whether you’re likely to develop the disease or not. It merely outlines your risk.
Say you were identified as being a carrier for the e4 variant, there’s a whole slew of emotions that you’re bound to go through when you discover that you’ve tested positive. For a result that isn’t definitive and for a disease that you might never develop, you’ll be exposed to fear, excess worrying and potentially depression that becomes debilitating. Additionally, it can lead you to make life-altering decisions based on tests that aren’t thorough in the results they deliver. Testing for one variant is not enough to make a medical diagnosis and this is clearly stated on each company’s website.
How Much Does Genetic Testing for Alzheimer’s Cost?
The cost of the genetic testing for Alzheimer’s varies widely depending on which test you take. For example, 23andMe lists the cost of the test as $199 on their website, while ADx has their version for $159 with a one-time $40 lab fee as of January 2019. If you have the test done in a laboratory or a medical office, it can cost you several hundreds of dollars because it’s more thorough. It tests for more markers in your DNA than the direct-to-consumer tests do and offer a more realistic outlook on whether you’re likely to develop Alzheimer’s disease.
Are the Tests Covered by Insurance?
This really depends on where you have the testing done and if it’s prescribed by your physician. If you have your tests done in a medical office, chances are all or a portion of the test will be paid for by your insurance, especially if it’s done as a diagnostic measure and not just for informational purposes. If you use a direct-to-consumer saliva-based test, insurance will not cover the cost of the kit you receive or the analysis fee. The companies also state on their websites that they do not take insurance and you’re responsible for the fees. In some cases, you may be eligible for reimbursement, but this is something that you need to clear with your insurance company beforehand.
Symptoms and Stages of Alzheimer’s Disease
There are several symptoms that doctors look for in order to diagnose Alzheimer’s disease. These progressively worsen over the lifespan of the disease, which can be a few years or even up to two decades, depending on how slow or fast the progression is. There are three stages: early, middle and late.
Early stage Alzheimer’s occurs at the onset of the disease. It starts with a person having problems concentrating or remembering simple things such as a person’s name, a book or article that they’ve just read. They may also lose objects or experience difficulty with organizing and planning. These can be warning signs, especially if they were strengths until recently.
The middle stage of Alzheimer’s is a little more advanced and comes with increasingly worsening memory issues that involve patients having difficulty remembering where they live or their telephone number. It’s not uncommon for a person with middle stage Alzheimer’s to undergo personality changes and even lose control of their bladder. Their functionality is decreasing slowly, but steadily. While they may still be able to live independently, the potential for wandering makes them a threat to their own safety. It’s at this stage you should start considering what you will do for future care when it becomes necessary.
Late stage Alzheimer’s presents with severe symptoms that require ongoing care, usually around the clock. During this stage, you can expect to see very little awareness and significant memory loss, to the point that they may remember you one hour and forget you the next. Additionally, it’s not uncommon for them to be susceptible to serious infections and to lose most of their motor function and physical capabilities.
When Is Alzheimer’s Disease Diagnosed?
Alzheimer’s is diagnosed in various ways. When symptoms first start to appear significant, doctors will want to rule out any other potential issues through testing, because other conditions can cause similar problems. Interviews with close friends and family can provide insight into any recent changes in the patient’s behavior and brain-imaging tests can help identify areas of weakening in the brain symbolic of dementia. When all other causes have been ruled out and a steady decline is evident, the doctor will make the call to diagnose the patient with Alzheimer’s and help family members prepare for what’s ahead.
When it comes to taking any kind of DNA test, knowledge is power. When you know what to expect from the results, it makes them along with your stated risk factors easier to understand. If you do get a positive test result for the Alzheimer’s e4 variant, make sure you speak with a genetic counselor or your physician before making any life-altering decisions.