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Predictive genetic testing for Alzheimer's disease: impact upon risk perception
Theresa M Marteau1, Scott Roberts, Susan LaRusse
1Psychology and Genetics Research Group, Institute of Psychiatry, King's College London, London, UK. theresa.marteau@kcl.ac.uk
Summary
Genetic testing for Alzheimer's disease (AD) impacts risk perception. Negative APOE results lower perceived risk, while positive results do not change it, avoiding false reassurance.
Area of Science:
- Neuroscience
- Genetics
- Psychology
Background:
- Alzheimer's disease (AD) poses a significant public health challenge.
- Genetic testing, particularly for the Apolipoprotein E (APOE) gene, is used to estimate AD risk.
- Understanding how genetic test results influence individuals' perceptions of their own risk is crucial for effective genetic counseling and patient management.
Purpose of the Study:
- To investigate the impact of disclosing genetic test results, specifically APOE genotype, on the risk perceptions of individuals at familial risk for Alzheimer's disease.
Main Methods:
- A randomized controlled trial involving 149 adult children of individuals with AD.
- Participants were assigned to receive lifetime risk estimates for AD based on clinical factors with or without APOE genotype information.
- Perceptions of Personal Risk (PPR) for AD were assessed six weeks post-intervention and correlated with actual risk estimates.
Main Results:
- Perceptions of Personal Risk (PPR) correlated significantly with actual lifetime risk estimates (r = 0.501; p < 0.0001).
- Individuals receiving an epsilon4-negative APOE test result showed significantly lower PPR compared to the control group (adjusted mean: 3.1 vs. 3.4; p = 0.014).
- No significant difference in PPR was observed between individuals with an epsilon4-positive APOE test result and the control group (adjusted mean: 3.4 vs. 3.4; p = 0.162).
Conclusions:
- Disclosure of genetic test results influences risk perceptions for Alzheimer's disease.
- An epsilon4-negative APOE genotype result leads to reduced perceived risk, while an epsilon4-positive result does not alter risk perception.
- The findings suggest that genetic testing can modify risk perception, but further research is needed to assess potential false reassurance in diverse testing contexts.