MOLECULAR-GENETIC PREDICTIVE TESTING FOR ALZHEIMERS-DISEASE - DELIBERATIONS AND PRELIMINARY RECOMMENDATIONS

Forty-one participants representing diverse professional backgrounds a ttended a workshop on genetic predictive testing for familial Alzheime r's disease (FAD) on January 23, 1993 at Surrey Place Centre in Toront o, Canada. Rapidly emerging molecular genetic findings in AD indicate that predictive testing is now technologically feasible for selected i ndividuals, although defining eligibility criteria remains problematic . Legal, ethical, biomedical, and psychosocial issues related to estab lishing predictive testing programs for AD were discussed at the works hop. This article reflects these discussions, provides the current bio medical background for them and examines the Huntington's disease (HD) predictive testing experience. Observations concerning molecular gene tic predictive testing for AD in light of its genetic heterogeneity an d clinical characteristics, such as usual later age of onset than HD, are presented. It is proposed that predictive testing for AD can now b e cautiously offered in a research setting primarily according to the recommendations contained within the Ethical Issues Policy Statement o n Huntington's Disease Molecular Genetics Predictive Test. However, in their application to AD, some points in the statement are considered to require emphasis, modification, or currently to be of uncertain app licability. This represents an initial step in an on-going process of debate concerning AD that will be required as new advances occur in ge netic and clinical research and in bioethics.