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Understanding tests after your visit.

What each test can add, where it falls short, and how it fits into the full picture.

After a visit, I may recommend one or more tests to better understand what is changing and why. Each test looks at the problem from a different angle. Not everyone needs every test.

A test is useful when it answers a clear question and has the potential to change what we do next. No single result replaces the history, examination, cognitive testing, or the story told by you and the people who know you well.

Inherited information

Genetic testing

Could inherited biology help explain a personal or family pattern?

Two different kinds of genetic information

Genetic testing can refer to two very different questions. Some tests look for rare genetic variants that can directly cause an inherited neurologic disease. Others look for common variants, such as APOE, that change risk but do not determine a person's future. Those results should not be interpreted in the same way.

The process usually begins with a careful personal and family history. A clinician or genetic counselor can then help decide whether testing is likely to be informative, which test fits the question, and what a positive, negative, or uncertain result could mean. The laboratory test itself usually uses blood or saliva. The conversation before and after testing is an important part of the test.

What a result can and cannot tell us

Rare variants in genes such as APP, PSEN1, and PSEN2 can cause inherited forms of Alzheimer's disease. Other genes can cause inherited forms of frontotemporal degeneration and related conditions. When a disease-causing variant is found, the result can help explain a family pattern and may have meaning for biological relatives.

APOE is different. It can increase or decrease the probability of Alzheimer's disease, but it is not a diagnosis and it cannot tell us whether, or when, a person will develop symptoms. A negative gene panel does not rule out a genetic contribution, and a variant of uncertain significance is not a diagnosis.

Testing can also uncover information a person did not expect. Results may have emotional, family, privacy, and insurance implications. These issues are worth discussing before a sample is sent, not after the result arrives.

From Dr. Anil

Why I may recommend it

Genetic testing is most informative when symptoms begin unusually early, when several relatives have had a similar condition, or when a disease-causing variant is already known in the family. APOE testing may also be discussed when certain anti-amyloid treatments are being considered because it can contribute to treatment-risk counseling.

The goal is not to order the largest panel available. It is to choose the test that can answer the family's actual question and to interpret the result with the clinical history.

Learn more

Last reviewed September 2026 by Anil R. Wadhwani, MD, PhD.

When results return

How I will follow up your results

Results may appear in MyChart before the full interpretation is ready. A result is one part of the story.

  1. 01Released

    You and I receive portal results at the same time.

  2. 02Reviewed

    I may wait for several tests or review imaging personally before putting the story together.

  3. 03Explained

    I will contact you quickly if something needs urgent attention. If you do not hear right away, it usually means the result is not an emergency.

  4. 04Discussed

    I will send next steps in the portal, and we will review the results together at your next visit. A telemedicine follow-up can give us more time when needed.