Disclosing genetic risk for Alzheimer's dementia to individuals with mild cognitive impairment

被引：23

作者：

Christensen, Kurt D. ^{[1
,2
,3
]}

Karlawish, Jason ^{[4
]}

Roberts, J. Scott ^{[5
]}

Uhlmann, Wendy R. ^{[6
,7
]}

Harkins, Kristin ^{[4
]}

Wood, Elisabeth M. ^{[4
]}

Obisesan, Thomas O. ^{[8
]}

Le, Lan Q. ^{[5
]}

Cupples, L. Adrienne ^{[9
,10
]}

Zoltick, Emilie S. ^{[11
]}

Johnson, Megan S. ^{[8
]}

Bradbury, Margaret K. ^{[12
]}

Waterston, Leo B. ^{[13
]}

Chen, Clara A. ^{[14
]}

Feldman, Sara ^{[5
]}

Perry, Denise L. ^{[11
]}

Green, Robert C. ^{[3
,11
,15
,16
]}

机构：

[1] Harvard Pilgrim Hlth Care Inst, Dept Populat Med, Boston, MA 02215 USA

[2] Harvard Med Sch, Boston, MA 02115 USA

[3] Broad Inst Harvard & MIT, Cambridge, MA USA

[4] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA

[5] Univ Michigan, Dept Hlth Behav & Hlth Educ, Sch Publ Hlth, Ann Arbor, MI 48109 USA

[6] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA

[7] Univ Michigan, Dept Human Genet, Ann Arbor, MI 48109 USA

[8] Howard Univ, Dept Med, Coll Med, Washington, DC 20059 USA

[9] Boston Univ, Dept Biostat, Sch Publ Hlth, Boston, MA 02215 USA

[10] Boston Univ, Dept Epidemiol, Sch Publ Hlth, Boston, MA 02215 USA

[11] Brigham & Womens Hosp, Dept Med, Div Genet, 75 Francis St, Boston, MA 02115 USA

[12] Hemophilia Federat Amer, Dept Res, Washington, DC USA

[13] Maine Med Ctr, Ctr Outcomes Res & Evaluat CORE, Res Inst, Portland, ME 04102 USA

[14] Boston Univ, Biostat & Epidemiol Data Analyt Ctr, Sch Publ Hlth, Boston, MA 02215 USA

[15] Harvard Med Sch, Dept Med, Boston, MA 02115 USA

[16] Partners Personalized Med, Boston, MA USA

来源：

ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS | 2020年 / 6卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Alzheimer's disease; anxiety; apolipoprotein E4; cognitive dysfunction; dementia; depression; emotions; genetic testing; health behavior; humans; random allocation; risk assessment; risk;

D O I：

10.1002/trc2.12002

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction: The safety of predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia using apolipoprotein E (APOE) genotyping is unknown. Methods: We randomized 114 individuals with MCI to receive estimates of 3-year risk of conversion to AD dementia informed by APOE genotyping (disclosure arm) or not (non-disclosure arm) in a non-inferiority clinical trial. Primary outcomes were anxiety and depression scores. Secondary outcomes included other psychological measures. Results: Upper confidence limits for randomization arm differences were 2.3 on the State Trait Anxiety Index and 0.5 on the Geriatric Depression Scale, below noninferiority margins of 3.3 and 1.0. Moreover, mean scores were lower in the disclosure arm than non-disclosure arm for test-related positive impact (difference: -1.9, indicating more positive feelings) and AD concern (difference: -0.3). Discussion: Providing genetic information to individuals with MCI about imminent risk for AD does not increase risks of anxiety or depression and may provide psychological benefits.

引用

页数：9

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