P4-201: Age Group Differences in Response to Genetic Risk Assessment: Results from the Risk Evaluation & Education for Alzheimer’s Disease (REVEAL) Study
Alzheimer's & dementia(2006)
摘要
Given advances in treatment for Alzheimer's disease (AD), it is important to understand the impact of genetic risk assessment on asymptomatic individuals. We report here on a randomized clinical trial (RCT) that examined the impact of risk assessment, including apolipoprotein E (APOE) genotype disclosure, on first–degree relatives of people with AD. To assess age group differences in response to genetic risk assessment for AD. In this four–site RCT, asymptomatic adult children and siblings of AD patients (n = 280, mean age = 58 years, 70% female, 19% African American) were provided genetic risk assessment. Estimates of lifetime risk of disease (range: 13–77%) were derived from large–scale genetic epidemiology studies of AD and incorporated gender, ethnicity, family history, and APOE genotype information. We assessed participants' response to risk assessment in the following domains: 1) psychological impact, as assessed by standard measures of anxiety and test–specific distress, and self–reported concern about developing AD; 2) recall of risk information; and 3) health behaviors to reduce disease risk (e.g., diet, exercise changes). We examined differences in these domains by age group (below 60 years vs. 60 years and above), controlling for gender, ethnicity, and APOE status (ϵ4+ vs. ϵ4–). At six weeks following disclosure of risk information, the younger group scored marginally higher on measures of anxiety (mean BAI score = 3.9 vs. 2.9, p = .07), and test–specific distress (mean IES score = 5.3 vs. 3.6, p = .07) and was more likely to endorse concern about developing AD (74% vs. 51%, p < .0001). The younger group was more likely to correctly recall their APOE genotype (69% vs. 51%, p = .002) and lifetime risk estimate (74% vs. 50%, p < .0001). No group differences were found regarding health behavior changes. Findings suggest important age group differences in response to genetic risk assessment for AD. Despite being at more imminent risk for AD, following risk disclosure, older participants were less concerned about developing the disease, less likely to recall their personalized risk information, and no more likely to be engaged in health behaviors to reduce disease risk.
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