
Simple blood tests may soon be able to deliver news about your cognitive health - helloworld
https://www.nytimes.com/interactive/2017/11/17/opinion/sunday/What-if-You-Knew-Alzheimers-Was-Coming-for-You.html
======
otakucode
Does 'simple' mean 'you can buy it in Amazon and perform it in the privacy of
your own home'? Because needing to book an office visit with someone who has
had about a decade of medical training just to get the test done is not
exactly 'simple' in my book. And sharing those results with the increasingly
invasive systems of insurance and government and otherwise doesn't fill me
with anticipation.

Overall I definitely do want to know, though. If I know that I am highly
likely to contract dementia I can start doing things to attempt to combat it,
or at least plan 5 or so years before that point to begin using hard drugs.
You don't get any money back if you leave your body in good shape. I'd prefer
to slide it smoking and smouldering across the finish line, missing both
bumpers and with only one headlight hanging out. Then explode.

~~~
frankling_
Nicely put. However, it does take some excellent judgement to avoid an
extended crawl across the last few meters.

------
tabeth
There are three realities:

1\. The actions you should take if you knew that a serious disorder was coming
for you will probably be beneficial one way or another.

2\. There is nothing you can do about Alzheimers.

3\. The only reason you wouldn't live the best, healthiest life you could now
is because of an incorrect notion that you'll probably be fine until some set
time (e.g. retirement)

Knowing these things, and the fact that stress has a negative effect on your
health should compel anyone who reads the article to just live a sustainable
life.

Since everyone dies and everyone knows it, the priority should be on living a
nice life, free from the illusion that you'll live any given duration.
Ideally, being diagnosed with something like Alzheimers would result in a
shrug, just like how you would shrug if someone told you you're gonna die one
day.

~~~
dsp1234
_Alzheimers would result in a shrug, just like how you would shrug if someone
told you you 're gonna die one day._

Alzheimer's isn't like being dead though. It's an incredibly painful reminder
to everyone you've every loved that you are no longer "you", but they have to
take care of you every day anyways. Painfully re-opening wounds every time you
don't remember who they are, or hurt yourself from confusion. It's a
continuous living purgatory for your loved ones, with you gone but not gone.

I'd rather live the best, unhealthiest life, and hope I'm dead dead from other
causes before I can cause so much pain to the ones I love.

~~~
bdamm
Indeed. Personally I am confused by those wishing to die in their sleep. I'd
prefer to be totally awake, cognitively aware that I'm dying. People think I'm
joking when I say I'd like a violent death, if the alternative is Alzheimer's.

The trouble is a) knowing that I have it and b) having the drive to annihilate
myself before I no longer can do it myself. Fortunately I live in a state
where suicide is legal and available by pill, and that's a great option if I
can't build up the drive to rig my death some other way.

~~~
ohhhlol
> Fortunately I live in a state where suicide is legal and available by pill

for Alzheimer's?

[http://assisted-dying.org/blog/2011/01/10/can-an-
alzheimers-...](http://assisted-dying.org/blog/2011/01/10/can-an-alzheimers-
victim-end-their-own-life/)

'There is nowhere in the U.S. someone with Alzheimer’s disease can legally
commit suicide with the help of a physician or friend. (Suicide itself is not
a crime.) People with Alzheimer’s are not considered competent, and the
disease is generally not considered terminal because a person often does not
die within six months of a diagnosis.'

------
llamataboot
I have this variant. AMA

(It hasn't been traumatic knowledge for me -- anyone with severe dementia in
their biological family knows that there is some heredity there, whether or
not they know they have this particular gene variant)

~~~
bri3d
I also learned I have one variant (not two) and was already fairly aware as
well due to my family history. I already live as healthy a life as I can and
focus on enjoying it. Can't really do much of anything else.

To me the greatest benefit of this knowledge is being able to prepare loved
ones and family for the inevitable - beyond that, there's not really much to
be done and the knowledge hasn't really impacted me much.

~~~
Retric
Their are some financial implications as to how much and what long term care
insurance to have.

~~~
fencepost
Regarding long term care, I have a relative who ended up on disability in
their 40s and I pushed them hard to get an appropriate supplemental plan with
Medicare to be sure they'd have coverage - eligibility to purchase that
coverage is only for 6 months when you first get on disability, then wait
until 65.

It basically came down to "with your issues, what are the odds you'll need to
spend a few weeks in rehab after a bad fall within the next 20-25 years?"

------
ams6110
Get my affairs in order, then arrange for a quick death. I have no desire to
become a burden on my children or anyone else.

~~~
mythrwy
_Due to a bug in our system we inadvertently provided some of our users with
results from other patients._

Point being, watch the weather and plan, fine, but don't become certain until
you see rain falling from the sky.

------
chiefalchemist
Pardon the editorial (I realize it's not very HN) but this type of fear
mongering fluff does the public more harm than good.

The point being epigenetic is real. It does the general public more harm than
good to perpetuate the myth that they (via lifestyle, diet, etc.) have no say
in their genetic destiny.

No doubt sometimes some of these genes really matter. But often they are
dormant notes of what might be if you don't take care of yourself.

p.s. I just finished reading "Grain Brain." Regardless of what you think about
gluten, he makes very strong case for: where you take your body, your brain is
going to follow. He mentions Alzheimer's often.

~~~
Danihan
>p.s. I just finished reading "Grain Brain." Regardless of what you think
about gluten,

It's not just gluten. Look into enrichment. [https://cdn-
images-1.medium.com/max/1600/0*pBs90R1LfdGOfpTS....](https://cdn-
images-1.medium.com/max/1600/0*pBs90R1LfdGOfpTS.png)

Most people are actually sensitive to the additives added to fortified wheat
sold in the States, especially Vitamin B[0] and Iron[1].

[0]: [https://freetheanimal.com/2016/05/enrichment-promotes-
everyt...](https://freetheanimal.com/2016/05/enrichment-promotes-
everything.html)

[1]: [https://freetheanimal.com/2015/06/enrichment-theory-
everythi...](https://freetheanimal.com/2015/06/enrichment-theory-
everything.html)

~~~
chiefalchemist
Yup. Agreed. It's just some people are fond of latching on to anything
"...gluten..." and then using that to push back againt. I didn't want to get
into that politics, and wanted to recommend it as a brain hack type of manual.
At least that's how I see it.

------
ninjakeyboard
I eat centrophenoxine and racetams and meditate ~daily. I quit drinking/using
anything stronger than caffeine. Try to be good to myself.

~~~
amelius
Wow, just read this on Wikipedia:

> Meclofenoxate (centrophenoxine), as well as DMAE, have been found to
> increase the lifespans of mice by 30–50%, and thus may be anti-aging
> drugs/supplements.

Are you taking it for a specific reason? Or do you consider this a generally
good supplement?

~~~
hannob
> Wow, just read this on Wikipedia: > > Meclofenoxate (centrophenoxine), as
> well as DMAE, have been found to increase the lifespans of mice by 30–50%,
> and thus may be anti-aging drugs/supplements.

Have you also checked the source? It's not a scientific publication, it's a
claim from a book by a quack.

~~~
jz_
> Have you also checked the source? It's not a scientific publication

That's probably something to do with Wikipedia's editing guidelines these
days. They have a rule against using primary research citations. Only
literature reviews, books, and other secondary sources are acceptable.

I found the original source for the claim, which may be no better for
supporting the claim for a number of reasons (why has this not been
replicated, or did replication fail?):

[http://www.sciencedirect.com/science/article/pii/05315565739...](http://www.sciencedirect.com/science/article/pii/0531556573900247)

Effect of dimethylaminoethyl p-chlorophenoxyacetate on the lifespan of male
Swiss Webster albino mice, J Exp Gerontol 8: 177, 1973

Author: R. Hochschild of "Microware Instruments Co" of California.

doi (for sci-hub): 10.1016/0531-5565(73)90024-7

[http://www.sciencedirect.com/science/article/pii/05315565739...](http://www.sciencedirect.com/science/article/pii/0531556573900247)

Note: If anyone is actually interested in the field of biogerontology, I
recommend following the
[https://www.fightaging.org](https://www.fightaging.org) blog for
editorialisation of news and research papers coming out of the field.

~~~
charlieflowers
> That's probably something to do with Wikipedia's editing guidelines these
> days. They have a rule against using primary research citations.

Jeez. I haven't paid much attention, but every time I hear something about
Wikipedia's editing guidelines, they're getting it horribly wrong.

~~~
keganunderwood
Sorry for off topic but it is a difficult topic and goes beyond Wikipedia. I
read on hacker news the complaints that many (even peer reviewed) studies are
never reproduced because there is no incentive to reproduce/verify someone
else's work. Also, I've read that the "sugar lobby" may have been behind
previous studies linking eating fatty food with obesity. Given these facts,
how do we create guidelines that allow original research?

------
jjawssd
Can Alzheimer's disease also be known as Type 3 diabetes?

"Brain insulin resistance (diabetes) is very much like regular diabetes," de
la Monte said. "Since the underlying problems continue to be just about the
same, we believe that the development of new therapies would be applicable for
all types of diabetes, including Alzheimer's disease, which we refer to as
Type III diabetes."

Suzanne M. de la Monte, Edward Re, Lisa Longato, Ming Tong. Dysfunctional Pro-
Ceramide, ER Stress, and Insulin/IGF Signaling Networks with Progression of
Alzheimer’s Disease. Journal of Alzheimer's Disease, June 22, 2012,
supplement; DOI: 10.3233/JAD-2012-111728

Same author four years prior:

"brain insulin resistance is sufficient to cause AD and that additional
significant abnormalities, such as ongoing DNA damage and mitochondrial
dysfunction, are required."

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/)

~~~
trendia
Your last quote is the _opposite_ of what the paper says. The authors write
that insulin resistance is _not sufficient_ to cause AD and that other things
are required:

> Therefore, T2DM and obesity may contribute to, i.e., serve as cofactors of
> AD but by themselves are probably not sufficient to cause AD. Moreover, the
> findings in the T2DM/obesity model indicate the _unlikelihood_ [emphasis
> here] that brain insulin resistance is sufficient to cause AD and that
> additional significant abnormalities, such as ongoing DNA damage and
> mitochondrial dysfunction, are required.

------
hourislate
I know genetically for some this may be unavoidable but perhaps by living a
healthy life you could delay it to a point where you would pass away before it
took over.

Obesity, Insulin Resistance, have been linked to this disease/condition. Maybe
regular fasting, exercise, taking supplements (Lions Mane come to mind), CBD
oil, coconut oil, medications like Metaformin, etc might help. It would be
worth a shot since there are no real alternatives at the moment.

~~~
0xcde4c3db
That might have the opposite effect, since Alzheimer's rates go up
~exponentially after age 65 or so.

------
tequila_shot
If I knew Alzheimer's were coming for me, I'd start meditating now. I
currently do mindful meditation everyday, and have been doing since 2008.

~~~
Buttons840
I've had the same thought. I don't know that the meditation would slow down
dementia, but I could hopefully cultivate mindfulness and cheerfulness, lest I
become more and more frustrated at the world as I begin to lose comprehension
of it. Also, some good drugs would be nice too.

------
mhkool
I am getting a bit irritated when I read the news about Alzheimers since for a
couple of years there is a treatment which was developed by Dr Dale Bredesen.
Dr Bredesen looked at all factors which were linked with Alzheimers and
combined many together into a treatment strategy. He also defined 3 subtypes
of Alzheimers. The result is that his treatment cures 9 out 10 patients with
mild Alzheimers. The fact that Bill Gates invests in new drug treatments is
insane.

------
arikr
Does anyone know an ETA on when this may be usable?

------
LordHumungous
Why would you ever want to know this.

~~~
intro-b
for me, using 23andme and other components of genetic testing related to
health risk factors (all four of my grandparents passed away from or are
currently battling cancer) helped me make some long-term decisions regarding
my habits and lifestyle, and it did influence my decision to go into a
healthcare-related field as a career. I like to think of it more as "I'd like
to know what I'm up against," rather than "I have a morbid curiosity about
what non-accident deaths will most likely happen to me"

------
jksmith
I'd fly to Africa, walk out into a herd of Cape Buffalo, and slap one of those
bastards right in the face as hard as I could. Why people want to live forever
is beyond me.

~~~
adventured
> Why people want to live forever is beyond me.

I have the same reaction when someone says they only want to live ~80 years.
What a terrible outcome when the universe is so massive. There's so much to
see, do, try, experience and learn.

There are trillions of galaxies out there and every one of them is different.
I could easily happily fill thousands of years just in our solar system.

I'd like to live long enough to explore other solar systems and galaxies and
yet the earth by itself is far too large to ever meaningfully explore in a few
lifetimes, much less one.

I simply want to see what all is out there. Now, granted, plenty of people
consider that a very selfish desire (based on a scarce resources premise) and
I'll openly admit to that. It's about as selfish a desire as there can be. I'm
ok with that, it's also not a desire that can be actual (not in my lifetime
anyway). As such it's equivalent to wanting to be able to fly around like
Superman. My desire to learn and experience more will never halt, as such my
desire to live an _extremely_ long time will never cease.

~~~
jansho
But don’t forget, our brain is limited to some extent and _won’t_ be able to
hold that amount of information. You’ll live to a thousand years, but you’ll
probably only vividly remember the last five decades, and some smatterings
from the past. Is that really meaningful?

Actually I also desire for longevity for reasons like yours, but I’ve been
thinking, perhaps it’s more important to measure the quality of experiences
rather than number of years. Wisdom, basically - and from history, we know
that a deep level of that is attainable irrespective of background and age.

And then, there is also the eventual apathy towards life and wonder. I’m most
afraid of that.

Edit: typo

~~~
mikestew
_You’ll live to a thousand years, but you’ll probably only vividly remember
the last five decades, and some smatterings from the past. Is that really
meaningful?_

I just want to get really good on the mandolin, and that’s probably going to
take a few decades more than I actually have. And that’s what I think about
when I watch movies about immortals ( _Highlander_ and the like). While you’re
thinking “oh, the things he must have seen! The rise and fall of empires! The
loves won and lost!”, I’m thinking, “he must play a hell of a violin by now.”
So I might only remember the last fifty years, but I’ll _always_ be better on
the mandolin than I was last year. Who knows, maybe I’d have time to get good
on the fiddle?

~~~
jansho
> I just want to get really good on the mandolin

There’s something sweet about that :) But a few centuries later, you sure
you’ll still enjoy it?

Myself, I’m prone to getting frustrated that I can’t learn faster, but we just
have to make peace with that. Being in ignorance and pain can sometimes be
what makes life so poignant. Who knows, there will _never_ be enough years
that we can be satisfied with.

I better take off my musing hat now..

------
miguelrochefort
Soon™

