Biomarkers may allow identification of diseases before patients even show symptoms.
Currently, clients are only roughly able to estimate their chances of being diagnosed with a chronic illness based on factors such as their age, weight, fitness level, and family history. In the near future, that could change. Advances in medicine may provide us with the ability to predict whether an individual is likely to suffer from costly diseases such as Alzheimer’s dementia, amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), Parkinson’s disease, and certain types of stroke and cancer. These advances in diagnostics could have big implications for CPAs.
Scientists are developing ways to identify biological markers, or biomarkers: changes that indicate someone is in the very early stages of an illness. For example, Alzheimer’s once could only be identified in the late stages of the disease, when a patient was already significantly cognitively impaired. Now, Alzheimer’s can be diagnosed when a patient is exhibiting only mild cognitive impairment through brain imaging or the identification of abnormal proteins in cerebrospinal fluid. By testing for biomarkers, doctors can determine whether a patient suffering from mild cognitive impairment will develop Alzheimer’s. In 2011 the National Institute on Aging and the Alzheimer’s Association published criteria for the diagnosis of Alzheimer’s based on biomarkers.
Research into biomarkers is still in its early stages. Clinical biomarker tests for most diseases are not available to patients yet. However, testing for biomarkers is still a trend CPAs will want to keep their eyes on. Early diagnosis of serious illness could prove beneficial for financial planning purposes, and there may be medical, emotional, and social benefits for patients and their families.
For example, early diagnosis could influence the retirement planning process. As diagnostics advance, more clients will have more information to include as part of the retirement plan. With this knowledge, CPAs may be able to better estimate health care costs in retirement.
The planning benefits of earlier diagnosis might include the ability to:
- Create a preliminary care budget years earlier
- Update legal documents and estate plans
- Reassess the client’s insurance coverage
- Create an end-of-life plan as needed
- Review the family budget to account for a change in employment benefits
- Plan for the survivor if the illness is terminal.
- Plan for the unexpected death of the caregiver.
Is there an ethical dilemma to be considered here?
James Sullivan, CPA/PFS, is a financial planner in Wheaton, Ill. He specializes in working with clients, and the families of clients, suffering from chronic illness. To comment on this article or to suggest an idea for another article, contact senior editor Courtney Vien at Courtney.Vien@aicpa-cima.com.