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本文引用的文献

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Combining blood-based biomarkers to predict risk for Alzheimer's disease dementia.联合基于血液的生物标志物预测阿尔茨海默病痴呆风险。
Nat Aging. 2021 Jan;1(1):26-28. doi: 10.1038/s43587-020-00008-0.
2
'That would be dreadful': The ethical, legal, and social challenges of sharing your Alzheimer's disease biomarker and genetic testing results with others.“那将是可怕的”:与他人分享阿尔茨海默病生物标志物和基因检测结果所面临的伦理、法律和社会挑战。
J Law Biosci. 2021 May 19;8(1):lsab004. doi: 10.1093/jlb/lsab004. eCollection 2021 Jan-Jun.
3
Disclosure of preclinical Alzheimer's disease biomarker results in research and clinical settings: Why, how, and what we still need to know.临床前阿尔茨海默病生物标志物结果在研究和临床环境中的披露:为何披露、如何披露以及我们仍需了解的内容。
Alzheimers Dement (Amst). 2021 Feb 20;13(1):e12150. doi: 10.1002/dad2.12150. eCollection 2021.
4
Blood-based biomarkers for Alzheimer's pathology and the diagnostic process for a disease-modifying treatment: Projecting the impact on the cost and wait times.用于阿尔茨海默病病理学的血液生物标志物及疾病修饰治疗的诊断流程:预测对成本和等待时间的影响
Alzheimers Dement (Amst). 2020 Aug 18;12(1):e12081. doi: 10.1002/dad2.12081. eCollection 2020.
5
Short-term Psychological Outcomes of Disclosing Amyloid Imaging Results to Research Participants Who Do Not Have Cognitive Impairment.向无认知障碍的研究参与者披露淀粉样蛋白成像结果的短期心理结果。
JAMA Neurol. 2020 Dec 1;77(12):1504-1513. doi: 10.1001/jamaneurol.2020.2734.
6
Cognitively unimpaired adults' reactions to disclosure of amyloid PET scan results.认知正常成年人对淀粉样 PET 扫描结果披露的反应。
PLoS One. 2020 Feb 13;15(2):e0229137. doi: 10.1371/journal.pone.0229137. eCollection 2020.
7
Disclosure of Amyloid Status for Risk of Alzheimer Disease to Cognitively Normal Research Participants With Subjective Cognitive Decline: A Longitudinal Study.认知正常的主观认知下降研究参与者阿尔茨海默病风险的淀粉样蛋白状态披露:一项纵向研究。
Am J Alzheimers Dis Other Demen. 2020 Jan-Dec;35:1533317520904551. doi: 10.1177/1533317520904551.
8
Disclosure of amyloid PET scan results: A systematic review.淀粉样 PET 扫描结果的披露:系统评价。
Prog Mol Biol Transl Sci. 2019;165:401-414. doi: 10.1016/bs.pmbts.2019.05.002. Epub 2019 Jun 13.
9
Why Older Adults and Their Children Disagree About In-Home Surveillance Technology, Sensors, and Tracking.老年人及其子女为何在家庭监控技术、传感器和追踪方面存在分歧。
Gerontologist. 2020 Jul 15;60(5):926-934. doi: 10.1093/geront/gnz068.
10
Attitudes Toward Physician-Assisted Death From Individuals Who Learn They Have an Alzheimer Disease Biomarker.得知自己有阿尔茨海默病生物标志物的个体对医生协助死亡的态度。
JAMA Neurol. 2019 Jul 1;76(7):864-866. doi: 10.1001/jamaneurol.2019.0797.

家庭成员对认知正常的老年人淀粉样蛋白-β PET 扫描结果的学习的看法。

Family members' perspectives on learning cognitively unimpaired older adults' amyloid-β PET scan results.

机构信息

Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

出版信息

J Am Geriatr Soc. 2021 Nov;69(11):3203-3211. doi: 10.1111/jgs.17362. Epub 2021 Jul 12.

DOI:10.1111/jgs.17362
PMID:34252201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8595546/
Abstract

BACKGROUND/OBJECTIVES: Disclosure of Alzheimer's disease (AD) risk information to cognitively unimpaired older adults may become more common if preclinical AD is shown to be identifiable and amenable to treatment. Little, however, is known about how families will react to this information.

DESIGN AND SETTING

Semi-structured telephonic interviews.

PARTICIPANTS

Seventy study partners (mean age = 68 [±11]; 50% female; 70% spouses/significant others; 18% children, siblings; 12% friends) of cognitively unimpaired adults who learned a personalized AD dementia risk estimate and an amyloid-β PET scan result through their participation in preclinical AD research.

MEASUREMENT

Interviewees were asked about their desire for information regarding their family member's AD dementia risk, baseline expectations of risk, understanding of amyloid-β PET scan results, and the impact of AD dementia risk information on emotions, health behaviors, and future plans, as well as on perceptions of their family member's or friend's memory.

RESULTS

Interviewees generally understood the AD dementia risk information (83%) and considered it valuable (75%). Risk information perceived as favorable elicited feelings of happiness and relief; unfavorable information elicited disappointment, as well as increased awareness of the participants' memory and monitoring for incipient changes in cognition. While noting that AD dementia risk information was not medically actionable at this time due to the lack of disease-modifying therapies, some interviewees described changes to their family members' and their own health behaviors and future plans.

CONCLUSION

Guidelines for the disclosure of AD dementia risk estimates and biomarker results to cognitively unimpaired adults should account for the needs and interests of individuals and their family members, who may step into a pre-caregiver role.

摘要

背景/目的:如果临床前阿尔茨海默病(AD)被证明是可识别的并且可以治疗,向认知正常的老年人披露 AD 风险信息可能会变得更加普遍。然而,对于家庭对这些信息的反应,我们知之甚少。

设计和设置

半结构化电话访谈。

参与者

70 名认知正常成年人的研究伙伴(平均年龄 68 [±11];50%为女性;70%为配偶/重要他人;18%为子女、兄弟姐妹;12%为朋友),他们通过参与临床前 AD 研究了解了自己的 AD 痴呆风险估计和淀粉样蛋白-β PET 扫描结果。

测量

受访者被问及他们对其家庭成员的 AD 痴呆风险信息的需求,对风险的基线预期,对淀粉样蛋白-β PET 扫描结果的理解,以及 AD 痴呆风险信息对情绪、健康行为和未来计划的影响,以及对其家庭成员或朋友记忆的影响。

结果

受访者通常理解 AD 痴呆风险信息(83%)并认为其有价值(75%)。有利的风险信息引起幸福感和宽慰感;不利的信息引起失望感,以及参与者对自己的记忆力的认识增加,并监测认知的早期变化。虽然注意到由于缺乏疾病修饰疗法,目前 AD 痴呆风险信息在医学上无法采取行动,但一些受访者描述了他们自己和家庭成员的健康行为和未来计划的变化。

结论

向认知正常的成年人披露 AD 痴呆风险估计和生物标志物结果的指南应考虑个人及其家庭成员的需求和利益,他们可能会扮演预护理者的角色。