Predictive Genetic Testing for Alzheimer's Disease: Impact upon Risk Perception

Marteau, Theresa M.; Roberts, Scott; LaRusse, Susan; Green, Robert C.

doi:10.1111/j.1539-6924.2005.00598.x

Cited by 47 publications

(42 citation statements)

References 23 publications

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“…32 There are other examples of psychological benefits accruing from negative biomarker test results such as testing for genetic susceptibility for cancer 33 or Alzheimer disease. 34 In other situations, biomarkers may serve as research tools by providing insights into disease mechanisms.…”

Section: Characteristics Of An Ideal Biomarkermentioning

confidence: 99%

Biomarkers of Cardiovascular Disease

2006

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Section: Characteristics Of An Ideal Biomarkermentioning

confidence: 99%

Biomarkers of Cardiovascular Disease

2006

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“…No studies were found that assessed risk perceptions following genetic testing for dominantly inherited AD, while five studies were identified that described risk perceptions following APOE testing (LaRusse et al, 2005;Marteau et al, 2005;LaRusse Eckert et al, 2006;Hiraki et al, 2009;Linnenbringer et al, 2010).…”

Section: Impact Of Genetic Testing On Risk Perceptionmentioning

confidence: 99%

To Know or Not to Know: An Update of the Literature on the Psychological and Behavioral Impact of Genetic Testing for Alzheimer Disease Risk

Rahman

Meiser

Sachdev

et al. 2012

Genetic Testing and Molecular Biomarkers

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Alzheimer disease (AD) is a genetically heterogenous disorder; in rare cases autosomal dominantly inherited mutations typically cause early-onset familial AD (EOAD), whereas the risk for late-onset AD (LOAD) is generally modulated by genetic variants with relatively low penetrance but high prevalence, with variants in apolipoprotein E (APOE) being a firmly established risk factor. This article presents an overview of the current literature on the psychological and behavioral impact of genetic testing for AD. The few studies available for presymptomatic testing for EOAD showed that only a very small proportion of individuals had poor psychological outcomes as a result. Initial interest in testing for EOAD decreases significantly after identification of a specific mutation in a kindred, suggesting that interest and potential for knowledge may not translate into actual testing uptake. The majority of individuals from both the general population and those w1th a family history of AD had positive attitudes towards, and were interested in, susceptibility testmg for APOE. Motivations for genetic testing included to provide information for future planning and to learn about one's own and one's children's risks of developing AD. Although susceptibility testing for APOE genotype is not currently recommended due to the lack of clinical utility, this review demonstrates that there is interest in testing and no obvious adverse psychological effects to those who have been tested.

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“…[5][6][7] These benefi ts might explain why so many adults tend to underestimate their personal risk of experiencing a CVD event. [8][9][10][11][12] Given the rapid emergence of genetic technologies that are likely to shape risk perceptions, 13 it is both timely and essential to investigate the long-term health impact of self-rated risk. We conducted a 15-year morRobert Gramling, MD …”

mentioning

confidence: 99%

Self-Rated Cardiovascular Risk and 15-Year Cardiovascular Mortality

Gramling¹,

Klein²,

Roberts³

et al. 2008

The Annals of Family Medicine

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PURPOSE Many individuals perceive their cardiovascular disease (CVD) risk to be lower than established clinical tools would estimate, yet little is known about the long-term consequences of holding such optimistic beliefs. We evaluated whether lower self-ratings of CVD risk are associated with lower rates of CVD death after addressing potential confounding by an extensive set of social and biologic CVD risk factors. METHODSWe conducted a 15-year mortality surveillance study of adults aged 35 to 75 years from southeastern New England (n = 2,816) who had no history of myocardial infarction. Baseline evaluation in 1990-1992 included household interview, anthropomorphic measures, and laboratory analyses. Outcomes were obtained using the National Death Index records through December 2005.RESULTS Rating oneself to be at lower-than-average risk for one's age and sex was associated with lower rates of CVD mortality among men (hazard ratio [HR] = 0.3; 95% confi dence interval [CI], 0.2-0.7) but not among women (HR = 0.9; 95% CI, 0.5-1.7). None of the following weakened the fi ndings among men: adjustment for baseline Framingham Risk Score, propensity score adjustment for both social and biologic factors, and censoring the fi rst 2 years of surveillance.CONCLUSIONS Lower self-ratings of CVD risk are independently associated with lower rates of CVD death among men. INTRODUCTIONR isk perception affects health behavior and emotional well-being among individuals facing a health threat. [1][2][3] When the behavior required to ameliorate the threat is a single event (eg, vaccination), 4 heightened perceptions of risk appear to motivate preventive action. In turn, successful completion of the preventive action facilitates reduction in risk perception. 4 Thus, holding higher risk perceptions can be benefi cial in some health contexts.The threat of cardiovascular disease (CVD), however, requires preventive actions that are not single events; they are multidimensional, ongoing, and effort-intensive. The preventive value of harboring higher perceptions of CVD risk is therefore less clear. An individual's failure to engage and sustain CVD preventive action can exacerbate negative emotions arising from threat perception, thereby leading to dysfunctional coping behaviors. In fact, holding optimistic perceptions of risk, whether through lack of awareness or denial, may protect against fear-related coping behaviors and the physiologic effects of stress that, in turn, can hasten the onset of CVD events. [5][6][7] These benefi ts might explain why so many adults tend to underestimate their personal risk of experiencing a CVD event. [8][9][10][11][12] Given the rapid emergence of genetic technologies that are likely to shape risk perceptions, 13 it is both timely and essential to investigate the long-term health impact of self-rated risk. We conducted a 15-year morRobert Gramling, MD 303SEL F -R AT ED C A R DIOVA SCUL A R RISK AND 15 -Y E A R MORTA LIT Y tality surveillance study of adults who rated their own CVD risk in the early...

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Predictive Genetic Testing for Alzheimer's Disease: Impact upon Risk Perception

Cited by 47 publications

References 23 publications

Biomarkers of Cardiovascular Disease

Biomarkers of Cardiovascular Disease

To Know or Not to Know: An Update of the Literature on the Psychological and Behavioral Impact of Genetic Testing for Alzheimer Disease Risk

Self-Rated Cardiovascular Risk and 15-Year Cardiovascular Mortality

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