阿尔茨海默病预测性检测的意愿及其对预先护理计划的影响：一项横断面研究。
Desire for predictive testing for Alzheimer's disease and impact on advance care planning: a cross-sectional study.
作者信息
Sheffrin Meera, Stijacic Cenzer Irena, Steinman Michael A
机构信息
Section of Geriatric Medicine, Division of General Internal Medicine Disciplines, Stanford University School of Medicine, Stanford, CA, USA.
Division of Geriatrics, University of California at San Francisco, San Francisco, CA, USA.
出版信息
Alzheimers Res Ther. 2016 Dec 13;8(1):55. doi: 10.1186/s13195-016-0223-9.
BACKGROUND
It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer's disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer's disease, and examined how using such a test may impact advance care planning.
METHODS
A cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer's disease (N = 874). Subjects were asked whether they would want to take a hypothetical free and definitive test predictive of future Alzheimer's disease. Then, imagining they knew they would develop Alzheimer's disease, subjects rated the chance of completing advance care planning activities from 0 to 100. We classified a score > 50 as being likely to complete that activity. We evaluated characteristics associated with willingness to take a test for Alzheimer's disease, and how such a test would impact completing an advance directive and discussing health plans with loved ones.
RESULTS
Overall, 75% (N = 648) of the sample would take a free and definitive test predictive of Alzheimer's disease. Older adults willing to take the test had similar race and educational levels to those who would not, but were more likely to be ≤75 years old (odds ratio 0.71 (95% CI 0.53-0.94)). Imagining they knew they would develop Alzheimer's, 81% would be likely to complete an advance directive, although only 15% had done so already.
CONCLUSIONS
In this nationally representative sample, 75% of older adults would take a free and definitive test predictive of Alzheimer's disease. Many participants expressed intent to increase activities of advance care planning with this knowledge. This confirms high public interest in predictive testing for Alzheimer's disease and suggests this may be an opportunity to engage patients in advance care planning discussions.
背景
在美国，老年人是否愿意接受一项预测未来患阿尔茨海默病的检测，以及检测是否会改变行为，目前尚不清楚。我们使用全国代表性样本，探究了谁会接受一项免费且确定的阿尔茨海默病预测检测，并研究了使用该检测可能如何影响预先护理计划。
方法
在2012年健康与退休研究中，对65岁及以上成年人进行了一项横断面研究，询问了有关阿尔茨海默病预测检测的问题（N = 874）。受试者被问及是否愿意接受一项假设的免费且确定的未来阿尔茨海默病预测检测。然后，想象他们知道自己会患阿尔茨海默病，受试者对完成预先护理计划活动的可能性从0到100进行评分。我们将得分>50分类为可能完成该活动。我们评估了与接受阿尔茨海默病检测意愿相关的特征，以及该检测将如何影响完成预先指示和与亲人讨论健康计划。
结果
总体而言，75%（N = 648）的样本愿意接受一项免费且确定的阿尔茨海默病预测检测。愿意接受检测的老年人与不愿意接受检测的老年人在种族和教育水平上相似，但年龄≤75岁的可能性更高（优势比0.71（95%CI 0.53 - 0.94））。想象他们知道自己会患阿尔茨海默病，81%的人可能会完成预先指示，尽管只有15%的人已经这样做了。
结论
在这个全国代表性样本中，75%的老年人愿意接受一项免费且确定的阿尔茨海默病预测检测。许多参与者表示有意利用这些信息增加预先护理计划活动。这证实了公众对阿尔茨海默病预测检测的高度兴趣，并表明这可能是一个让患者参与预先护理计划讨论的机会。
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