Addressing the Ethical, Policy, and Social Challenges of Preclinical Alzheimer Disease


People with no clinical signs of Alzheimer’s disease (AD) can be diagnosed with what is called pre-clinical AD using biomarker measures such as PET imaging and spinal fluid assays. But informing a patient of pre-clinical AD is not without its risks. Among the challenges to patients, researchers, clinicians and other professionals who interact with patients:

  • Safely and effectively communicating a diagnosis of pre-clinical AD. Patients differ in their desire to know whether or not they are at risk to develop AD dementia. Researchers and clinicians should establish guidelines and best practices on how to disclose a diagnosis of pre-clinical AD.
  • Setting up a process that effectively translates the diagnosis of pre-clinical AD into practice and policy. Clinical trials should be conducted to demonstrate whether an intervention such as a drug alters the risk predicted by the biomarker.
  • Adapting laws, regulations and professional practices to the diagnosis of pre-clinical AD. People with pre-clinical AD need assistance to plan for and monitor emerging disabilities related to driving, the workplace and financial management.

“The discovery of pre-clinical AD may be how we prevent the tsunami of AD dementia,” the author concludes, “but we must not drown in the challenges created by our own discovery.”