Donders Institute for Brain, Cognition and Behaviour
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Thesis defense Martha Smedinga (Donders series 519)

5 October 2021

Promotors: prof. dr. C. Klijn, prof. dr. M. Schermer (Erasmus MC), prof. dr. E. Richard
Copromotor: dr. E  Bunnik (Erasmus MC)

Diseased without symptoms. The moral desirability of Alzheimer biomarker testing

A growing number of people in the Netherlands seeks medical advice for their cognitive complaints; afraid that they will develop Alzheimer’s disease. At the same time, Alzheimer research is increasingly focussed on developing so called ‘Alzheimer biomarkers’ tests, e.g. via a brain scan, to diagnose the disease in earlier stages, or to predict dementia in those with no or mild cognitive impairment. Some physicians have started to offer such Alzheimer biomarkers tests in their practice, to those seeking medical advice for their cognitive complaints. However, its added value for diagnosing or predicting dementia remains uncertain, especially in the older adults. Moreover, there is no effective treatment available.

This thesis answers the moral question whether testing Alzheimer biomarkers in clinical practice is desirable. First, the arguments on both sides of the debate are gathered through a literature review and interviews with physicians. In addition, it is discussed how the framing of ‘Alzheimer’ can steer the weighing of the arguments in a debate. It includes a proposal on how to weigh the arguments in favour of and against Alzheimer biomarker testing, and, lastly, which lessons can be learned for upcoming research on Parkinson biomarkers.