Some of the bevy of news coming out of the International Conference on Alzheimer Disease has focused on identifying individuals with the disease earlier and more accurately, something researchers have been trying to do for years. But experts debate the value of screening or early detection of a disease for which there is currently no treatment that slows progression, and which could cause needless distress.
在国际老年痴呆症大会传出的诸多消息中，很多都是关于尽早并更为准确地确定人们是否 患上老年痴呆症。研究人员多年来一直在试图这么做。但专家们认为，筛检或早期检测这一疾病的价值还在讨论中。因为老年痴呆症目前还无药可救，只能延缓 病情恶化,还可能引发不必要的痛苦。
Although the course of Alzheimer’s disease is unique for every individual, there are many common symptoms. The earliest observable symptoms are often mistakenly thought to be “age-related” concerns, or manifestations of stress. In the early stages, the most commonly recognised symptom is memory loss，such as difficulty in remembering recently learned facts. When a doctor or physician has notified, and AD is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests, often followed by a brain scan if available. As the disease advances, symptoms include confusion, irritability and aggression, mood swings, language breakdown, long-term memory loss, and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. Individual prognosis is difficult to assess, as the duration of the disease varies. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed forty years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis.
虽然阿尔茨海默氏症(AD老年痴呆症)在不同人的身上其临床 表现是不一样的，但也有一些普遍的症状。最早可观察到的症状经 常被误认为是“年纪大”的关系,或者是压力大的表现。早期的时候， 最明显的症状就是失忆。例如，想不起近期发生的事。当医生或内科 大夫注意到并怀疑是老年痴呆症(AD)的时候，一般要通过行为评 估和认知测试，还可能进行脑电图检测来配合诊断。这种病如果恶 化的话，出现的症状有意识混乱、应激性兴奋、攻击行为、情绪波动、 语言不连续、长时记忆缺失以及因为感觉衰弱而出现的主动停药现 象。随着身体机能的渐渐缺失，最终将导致死亡。个体预诊断是比较 难的，因为病情各个阶段持续的时间是有很多种可能性的。AD在确 诊之前的发病期并不明确，可能会发病几年了还没有被察觉。一般 确诊之后的平均寿命还有7年。只有不到3%的个例可以在确诊后寿 命超过14年。
A small study in today’s New England Journal of Medicine examines the notion that learning about your genetic risk of Alzheimer^ could lead to anxiety and distress, and finds that disclosure doesn’t appear to cause an undue amount of psychological distress for those who test positive for a well-known risk factor.
美国《新英格兰医学期刊》杂志不久前刊登的一项小范围研 究显示，了解到你可能会因遗传而患上老年痴呆症风险时可能 会给你带来焦虑和痛苦。研究还发现，对那些确实有遗传到此病 基因的人来说，检测结果的公布似乎并不会给他们带来过度的 心理压力。
Researchers studied 162 people who had a parent with Alzheimer's but no symptoms themselves, and gave 111 of them information about whether they had a version of a gene, ApoE4, that is linked with an unusually high likelihood of developing the disease. The others weren’t told about their genetic risk.
研究人员对162名对象进行了研究，这些研究对象的父母中至少有一人患有老年痴呆症,但目前他们自己没有症状。其中的 111人被告知他们是否拥有ApoE4基因,其他人则没有被告知 基因风险。拥有ApoE4基因的人患上老年痴呆症的风险异常 的高。
The individuals who were ApoE4-positive were, predictably enough, significantly more distressed than those who were told they were ApoE4-negative—but the level of distress was “well below the clinical threshold for concern，” according to the authors.
研究人员表示，可以预见的是，较之那些被告知ApoE4基 因检测呈阴性的人，那些ApoE4基因检测呈阳性的人明显更 为痛苦——但悲伤的程度“明显低于需要担心的水平”。
Including those who tested both positive and negative, the group that was given genetic risk information was no more anxious, depressed or distressed than those who weren’t told. That proved true at six weeks, six months and one year after disclosure.
不管对ApoE4基因的检测结果是呈阳性还是阴性,那些得知遗传风险信息的人都不比没有 得知信息的人更加焦虑、抑郁或不安。这点在公开之后6周、6个月和1年后都是如此。
“These data support the psychological safety of disclosing data regarding genetic-counseling protocols to screened adult children of patients with Alzheimer’s disease who request such information, despite the frightening nature of the disease and the fact that disclosure has no clear medical benefit，”conclude the authors in their paper.
作者在研究报告中总结说尽管这种疾病令人恐惧，公开后也没有明显的医学上的益处,但 对于那些双亲中有痴呆症患者、主动进行了基因筛检并要求公开遗传信息的人来说，这项研究结 果支持了公开行为本身带来的心理安全感
Health Blog Question of the Day: Given the chance, would you take a test to find out whether you're ApoE4-positive?
健康博客今日调查:如果有机会,你会花点时间看看你是否是ApoE4阳性吗？