On the reconceptualization of Alzheimer’s disease
In the hope of future treatments to prevent or slow down the disease, there is a strong movement towards an ever-earlier detection of Alzheimer’s disease (AD). In conjunction with scientific developments, this has prompted a reconceptualization of AD, as a slowly progressive pathological process wit...
| Auteurs: | ; |
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| Type de support: | Électronique Article |
| Langue: | Anglais |
| Vérifier la disponibilité: | HBZ Gateway |
| Interlibrary Loan: | Interlibrary Loan for the Fachinformationsdienste (Specialized Information Services in Germany) |
| Publié: |
[2019]
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| Dans: |
Bioethics
Année: 2019, Volume: 33, Numéro: 1, Pages: 138-145 |
| Classifications IxTheo: | NCH Éthique médicale |
| Sujets non-standardisés: | B
disease concepts
B early diagnosis B Alzheimer’s Disease B Pragmatism B biomarkers B Dementia |
| Accès en ligne: |
Accès probablement gratuit Volltext (Maison d'édition) Volltext (doi) |
| Résumé: | In the hope of future treatments to prevent or slow down the disease, there is a strong movement towards an ever-earlier detection of Alzheimer’s disease (AD). In conjunction with scientific developments, this has prompted a reconceptualization of AD, as a slowly progressive pathological process with a long asymptomatic phase. New concepts such as ‘preclinical’ and ‘prodromal’ AD have been introduced, raising a number of conceptual and ethical questions. We evaluate whether these new concepts are theoretically defensible, in light of theories of health and disease, and whether they should be understood as disease or as an at-risk state. We introduce a pragmatic view on disease concepts and argue that an evaluation of the reconceptualization of AD should also take its aims and effects into account, and assess their ethical acceptability. The reconceptualization of AD is useful to coordinate research into preventive strategies, and may potentially benefit future patients. However, in the short term, early detection and labelling of ‘preclinical AD’ can potentially harm people. Since there is no treatment available and the predictive value is unclear, it may only create a group of ‘patients-in-waiting’ who may suffer from anxiety, uncertainty and stigmatization, but will never actually develop dementia. We conclude that only if the promise of preventive medication materializes, will the reconceptualization of AD turn out unequivocally to be for the better. Otherwise, the reconceptualization may do more harm than good. |
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| ISSN: | 1467-8519 |
| Contient: | Enthalten in: Bioethics
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| Persistent identifiers: | DOI: 10.1111/bioe.12516 |
