IMPACT OF DISCLOSING GENETIC RISK FOR ALZHEIMER'S DISEASE TO PATIENTS WITH MILD MEMORY PROBLEMS. (11th November 2018)

• Record Type: Journal Article
• Authors: Christensen, K; Karlawish, J; Roberts, J; Obisesan, T; Le, L; Sutti, S; Green, R
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 422
• Page End: 422
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.1579
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: The psychological and behavioral impact of disclosing genetic risk for Alzheimer's disease (AD) to individuals with mild memory problems or potential caregivers is unknown. In a multi-site clinical trial, we randomized 114 patients with diagnoses of mild cognitive impairment (MCI) to receive risk estimates for converting to AD within three years based on age and MCI diagnoses alone or in conjunction with APOE genotyping. Six months following risk disclosure sessions, patients who received genotyping scored no higher than patients who did not receive genotyping on all psychological outcome scales, including the State-Trait Anxiety Index (36.7 vs 37.0, respectively, p=0.87), the 15-item Geriatric Depression Scale (2.3 vs 2.1, respectively, p=0.71), and the Impact of Event Scale (IES; 12.7 vs 13.3, p=0.80). Subanalyses showed more positive feelings about risk estimates and less concern about AD among participants who were APOE ε4-negative compared to participants who did not receive genotyping (both p<0.040). Similar statistically significant results were observed in patients' study partners. No differences were observed in patients' AD prevention behaviors, changes to insurance coverage, or changes in advance planning at 6 months except for medication use, which was higher among patients who were APOE ε4-negative compared to participants who did not receive genotyping (86% vs 54%, respectively, p=0.019). Results suggest that disclosing imminent risk for AD based on genetic testing does not increase short-term risks for psychological harms to MCI patients or close others, and reduces concern about AD while increasing positive feelings among patients who learn that they are APOE ε4-negative.