Early detection of Alzheimer's would allow for better financial planning

With new blood test, clients and families would benefit from additional time to save and make decisions about care

Nov 18, 2014 @ 4:21 pm

By Liz Skinner

A new blood test being developed to detect Alzheimer’s can identify the disease up to a decade before a clinical diagnosis can spot the signs, a development that should help financial advisers better plan for their clients’ future.

“From a planning aspect, it’s better to know ahead of time so you can figure out how to pay for all of the treatment and care, get your estate in order, and make legal preparations like health care directives,” said Bill Cummings, an adviser and founder of the Cummings Financial Organization.

The new test, described Monday by neuroscientist Dimitrios Kapogiannis at a Society for Neuroscience conference in Washington, would offer detection about seven years earlier than others in development. That translates into years of extra time for advisers to work with families to save money and insure for significant health care costs, as well as to make decisions about who is going to care for the person and where that care should be provided.

But the decision to have the test done is also controversial and once a patient knows they have the disease they may not be able to secure long-term-care insurance that could help them once their symptoms get worse. Positive results from this Alzheimer’s blood test also won’t foretell how long a person will live. There’s no real prediction for life expectancy after diagnosis of Alzheimer’s, or even after signs present themselves.

“With Alzheimer’s, you don’t know if you’re planning for 20 years or five years,” Mr. Cummings said.

Today, the families of Alzheimer’s patients often become caregivers and bear major financial costs. About 42% of Alzheimer’s family caregivers spend more than $20,000 a year and a third of those families spend $30,000 or more each year on care, according to estimates from a survey released Tuesday by Caring.com.

About 53% of families caring for someone with Alzheimer’s disease spent money on modifying homes for safety, including monitoring products, the survey found. Other costs include doctor visits, medicines, hospitalizations, in-home care giving and assisted-living facilities.

Joe Franklin, president of Franklin Wealth Management, said the tests may be a good thing to help people make preparations, including buying long-term-care insurance and having a durable power of attorney in place.

“The main thing is what steps you put in place to turn decision-making over to someone else in the family when the person starts to show signs,” Mr. Franklin said.

An InvestmentNews survey of 200 advisers earlier this year showed that about two-thirds already work with a household where a client is suffering from, or showing signs of, cognitive decline, yet only half of the respondents feel prepared to help those clients.

(More: Unraveling Minds — advisers deal with client dementia)

More than five million Americans have Alzheimer’s, the most well-known form of dementia, which mostly affects older people. But that number is expected to grow as the population ages. By 2050, nearly 16 million Americans could be living with Alzheimer’s if no cure is found, according to health officials.

Early next year, NanoSomiX, which sponsored Dr. Kapogiannis’ research, plans to market a blood test for researchers to use to detect Alzheimer’s. A version for doctors to use as a diagnosis tool would come later.

In analyzing a patient’s blood plasma, the firm’s technology measures biomarkers in the brain that can indicate Alzheimer’s disease early. Previously, markers of the disease could only be found through expensive brain imaging techniques or cerebrospinal fluid extraction.

Barbara Hanson, an independent long-term-care insurance agent, recommends anyone planning to take a test that predicts Alzheimer’s, breast cancer or other diseases, secure long-term-care insurance first.

Federal law passed in 2008 prohibits employers and health insurance issuers from discriminating against anyone based on what’s found in their DNA, or genetics. But life insurance, disability insurance and long-term-care insurance are not covered under this protection.

Insurers can’t require genetic tests, but if the results are part of an applicant’s medical record and the person has approved release of that record to the insurance company, those results can be used to decide whether to provide insurance, Ms. Hanson said.

“So far use of these predictive tests isn’t really showing up because not enough people are taking them, but it has the potential to,” Ms. Hanson said. “Where it goes in the future is anybody’s guess.”

There’s also an emotional decision to be made about whether to take the test.

Eileen Paddock, a gerontology expert and president of Elderflower Group, said she would never advise a family to take a test to uncover such a debilitating disease unless there was a cure.

“Most people fear Alzheimer’s more than they fear death,” she said. “The truth is, the end is very bad.”

Although there are some medications shown to temporarily help Alzheimer’s patients, there is no real treatment for those suffering from the disease, Ms. Paddock said.

Finding out that a disease like this is coming a decade before clinical symptoms are present would be “like pushing a fast-forward button on a lot of emotional pain and potential depression for the person and their family,” she said. “I see the financial planning benefits of getting the test, but that needs to be weighed against the emotional impact of you and your family knowing you’ll develop Alzheimer’s.”

Mr. Cummings understands this quite personally. His father had Alzheimer’s disease before he died a couple months ago, and the struggles of helping him with financial and health care decisions led Mr. Cummings to begin offering clients help in such situations.

Mr. Cummings also knows that research shows genes can play a role in who develops Alzheimer’s disease. He is leaning toward being tested for the disease.

“On the practical side, you know you should get tested,” he said. “But on the emotional side, you don’t want to know.”

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