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Why you should read this article: • To refresh your knowledge of the genetics of Huntington's disease • To enhance your awareness of the implications of pre-symptomatic genetic testing for Huntington's disease • To reflect on situations that require special consideration before genetic testing is conducted Huntington's disease is a fatal and progressive neurodegenerative disease characterised by a shrinkage of the brain, movement abnormalities and cognitive decline. It is an autosomal dominant disease caused by a DNA mutation in the huntingtin gene located on chromosome 4. Children with one parent affected by Huntington's disease have a 50% risk of inheriting the faulty gene. Genetic testing for Huntington's disease has been available for more than 20 years and can be used for pre-symptomatic or confirmatory testing. Healthcare professionals across a variety of specialties and settings, including primary care, may encounter patients who ask to be genetically tested for Huntington's disease. This article explains the genetics of Huntington's disease, describes its clinical diagnosis, identifies some of the implications of pre-symptomatic genetic testing and discusses situations that require special consideration before the decision to conduct genetic testing is made. The article is written from a US perspective, but the implications and challenges discussed are highly relevant in the UK. [ABSTRACT FROM AUTHOR]

Objectives: Despite extensive research on lifestyle factors that influence the risk of developing dementia, limited evidence exists on whether older adults adopt healthier habits post-diagnosis in the hope of preserving their quality of life., Method: Using panel data (1998-2014) from the Health and Retirement Study, this study investigated whether individuals who received a new dementia diagnosis were more likely to modify smoking and drinking behaviors than those without such a diagnosis. Propensity score weighting was used to adjust for observable differences between groups., Results: Older adults with a new dementia diagnosis were 2.8 times more likely to reduce alcohol consumption than those without such a diagnosis. This result was mainly attributable to "light" drinkers at baseline and appeared to fade over time. We found no statistically significant effect of a dementia diagnosis on smoking cessation or on reduction in the number of cigarettes smoked. These results were robust to multiple sensitivity tests, including the use of cognition scores to indicate dementia onset instead of self-reported physician diagnosis., Discussion: A new dementia diagnosis can serve as a window of opportunity that prompts some older adults to change habits related to alcohol consumption. This has important implications for clinical practice surrounding dementia diagnosis disclosure, the rates of which are currently much lower than other medical conditions., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)