Impacts of apolipoprotein E disclosure on healthy Asian older adults: a cohort study

Abstract

Background:The apolipoprotein E (APOE) genotype provides information about Alzheimer’s disease risk, yet genotype disclosure is discouraged due to concerns about possible distress. This is the first study investigating the psychological and behavioral impacts that genetic susceptibility testing for Alzheimer’s disease has in an Asian population.Methods:From March 2016 to November 2017, we ran a prospective cohort study at Duke-National University of Singapore Medical School. 280 healthy Chinese elderly filled in questionnaires that measured psychological symptoms and health behaviors, 1 week before and 6 weeks after APOE genotype disclosure. Responses from ε4-positive subjects (associated with greater Alzheimer’s disease risk) were compared to responses from ε4-negative subjects.Results:ε4 presence was not significantly associated with anxiety (p = 0.09) or depression (p = 0.25). No associations were found for changes to diet (p = 0.36), dietary supplements consumption (p = 0.90), physical activity (p = 0.15), or cognitive activity (p = 0.18).Conclusion:There is no evidence to suggest that disclosure of APOE to Asian populations was associated with any short-term adverse psychological or behavioral impacts.

Brain health registry GenePool study: A novel approach to online genetics research

“…Interestingly, 83% indicated that they would prefer to know whether they carried a gene that affected their risk of developing AD. This is in line with other studies surveying preferences for genetic results disclosure in the dementia field 55,56 and supports past studies demonstrating no acute negative psychological consequences of APOE results disclosure 57–59 . Consistent with many clinical studies, we chose not to disclose APOE results to participants.…”

“…This is in line with other studies surveying preferences for genetic results disclosure in the dementia field 55,56 and supports past studies demonstrating no acute negative psychological consequences of APOE results disclosure. [57][58][59] Consistent with many clinical studies, we chose not to disclose APOE results to participants. The issue of APOE disclosure is complex and evolving, especially in the context of an online registry, in which it is more difficult to provide access to a genetic counselor or other support system to accurately explain results and their implications.…”

Return of individual research results from genomic research: A systematic review of stakeholder perspectives

“…The first is the Australian study of 133 participants from the Cancer Council registry described above, which also included cancer patients and their family and friends [ 189 ]. The second reported on 280 cognitive healthy, Chinese English-speaking participants in Singapore that had APOE genotype testing [ 194 ]. Assessment using the Beck Anxiety Inventory (BAI) and Centre for Epidemiologic Studies Depression scale (CESD) showed no evidence of APOE genotype disclosure resulting in adverse psychological outcomes [ 194 ].…”

“…The second reported on 280 cognitive healthy, Chinese English-speaking participants in Singapore that had APOE genotype testing [ 194 ]. Assessment using the Beck Anxiety Inventory (BAI) and Centre for Epidemiologic Studies Depression scale (CESD) showed no evidence of APOE genotype disclosure resulting in adverse psychological outcomes [ 194 ]. In addition, they did not identify any significant associations between APOE e4 genotype and behavior changes, such as diet, supplement consumption, and physical or cognitive activity [ 194 ].…”