Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, USA.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
J Alzheimers Dis. 2021;79(2):559-572. doi: 10.3233/JAD-200993.
Cognitively normal (CN) older adults participating in Alzheimer's disease (AD) research increasingly ask for their research results-including genetic and neuroimaging findings-to understand their risk of developing AD dementia. AD research results are typically not returned for multiple reasons, including possible psychosocial harms of knowing one is at risk of a highly feared and untreatable disease.
We developed materials that convey information about 5-year absolute risk of developing AD dementia based on research results.
20 CN older adults who received a research brain MRI result were interviewed regarding their wishes for research results to inform material development (Pilot 1). Following material development, 17 CN older adults evaluated the materials for clarity and acceptability (Pilot 2). All participants were community-dwelling older adults participating in longitudinal studies of aging at a single site.
Participants want information on their risk of developing AD dementia to better understand their own health, satisfy curiosity, inform family, and future planning. Some articulated concerns, but the majority wanted to know their risk despite the limitations of information. Participants found the educational materials and results report clear and acceptable, and the majority would want to know their research results after reviewing them.
These materials will be used in a clinical study examining the psychosocial and cognitive effects of offering research results to a cohort of CN older adults. Future AD research may incorporate the return of complex risk information to CN older adults, and materials are needed to communicate this information.
参与阿尔茨海默病(AD)研究的认知正常(CN)老年人越来越多地要求了解他们的研究结果,包括遗传和神经影像学发现,以了解他们患 AD 痴呆的风险。由于多种原因,AD 研究结果通常不会返回,包括了解自己有患一种高度恐惧且无法治愈的疾病的风险可能带来的潜在心理社会危害。
我们开发了基于研究结果传达有关 5 年 AD 痴呆发病绝对风险信息的材料。
对 20 名接受研究脑 MRI 结果的 CN 老年人进行了访谈,了解他们对告知材料开发的研究结果的愿望(试点 1)。在材料开发之后,17 名 CN 老年人评估了材料的清晰度和可接受性(试点 2)。所有参与者均为居住在社区的老年人,在一个地点参与衰老的纵向研究。
参与者希望了解自己患 AD 痴呆的风险信息,以更好地了解自己的健康状况、满足好奇心、告知家人和未来规划。一些人表达了担忧,但大多数人希望了解自己的风险,尽管信息存在局限性。参与者认为教育材料和结果报告清晰易懂,大多数人在查看后会想要了解自己的研究结果。
这些材料将用于一项临床研究中,该研究检查向一组 CN 老年人提供研究结果对其心理社会和认知的影响。未来的 AD 研究可能会纳入向 CN 老年人返回复杂风险信息,并需要材料来传达这些信息。