Q. Our family has several members who have had Alzheimer's disease. My grandmother and mother both died from complications of Alzheimer's. My brothers and sister all have Alzheimer's now. I am the only one out of my siblings who does not have Alzheimer's. I worry about this constantly. Is there some kind of testing I could do to find out if I could get it in the near future?

A. Alzheimer's Disease (AD) appears to be a group of related disorders, rather than a single disease. AD may occur in both sporadic and familial forms. The latter may be either late or early onset. There is no genetic test that diagnoses or predicts AD with 100% accuracy. However, there is an association between late-onset familial AD [LOFAD] and a specific abnormal gene called APOE4. Other abnormal genes have also been implicated in the risk of familial AD.

Your family history of Alzheimer's Disease--if accurately diagnosed--may elevate your risk of developing AD, but that doesn't mean anything is written in stone, or that you will necessarily develop AD. If you are worried about developing Alzheimer's constantly, I think it would be useful to seek some professional counseling.

You might consider getting some genetic counseling, which would help you assess your level of risk. Contacting a major medical center near you would be one way to start. But I would also consider getting some psychological counseling, if you find that you are constantly ruminating on this issue.

Ideally, this would be with a mental health professional with special expertise in cognitive disorders such as AD, such as a geriatric psychiatrist. You can also find more information regarding diagnosis and support on the website of the Alzheimer's Association (www.alz.org). I hope all goes well for you.

Other Resources:

• More Questions on Alzheimer's Disease

November 2003

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