Disclosing Genetic Risk for Alzheimer's Dementia to Individuals With Mild Cognitive Impairment - PubMed

Disclosing Genetic Risk for Alzheimer's Dementia to Individuals With Mild Cognitive Impairment - PubMed

Disclosing Genetic Risk for Alzheimer's Dementia to Individuals With Mild Cognitive Impairment

Kurt D Christensen 1 2, Jason Karlawish 3, J Scott Roberts 4, Wendy R Uhlmann 5, Kristin Harkins 3, Elisabeth M Wood 3, Thomas O Obisesan 6, Lan Q Le 4, L Adrienne Cupples 7, Emilie S Zoltick 8, Megan S Johnson 6, Margaret K Bradbury 9, Leo B Waterston 10, Clara A Chen 11, Sara Feldman 4, Denise L Perry 8, Robert C Green 2 8 12 13, REVEAL Study Group

Affiliations 

• PMID: 32211507
 
• PMCID: PMC7087414
 
• DOI: 10.1002/trc2.12002

Abstract

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 non-inferiority 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.

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

© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.

Conflict of interest statement

Robert Green receives compensation for advising AIA, Applied Therapeutics, Biggs Institute, Helix, Humanity, Verily, and Veritas, and is a cofounder with equity in Genome Medical.