Apoe genotype knowledge and its impact on cognitive beliefs and performance

As genetic testing for Alzheimer's disease (AD) risk becomes increasingly accessible, it is important to understand how individuals respond to knowledge of their genetic risk. In this study, we examined whether awareness of being an APOE ɛ4 carrier, a genetic risk factor for late-onset AD dementia, adversely affects subjective and objective cognition. Participants were 195 cognitively unimpaired older adults (aged 63-79, Mage = 71.18), recruited from the Alzheimer's Prevention Initiative's GeneMatch program. All had undergone APOE testing, with 94 ε4 carriers and 32 non-carriers aware of their genotype, and 41 ε4 carriers and 28 non-carriers unaware. Subjective cognition was assessed using measures of memory control, attention control, and memory anxiety. Objective cognition was assessed with short-term memory, working memory, and episodic memory tasks. Results showed that ɛ4 carriers aware of their genotype were less confident that they could influence their cognitive functioning through effort and less confident that they could control their attention. Additionally, non-carriers aware of their genotype were less concerned they were currently developing AD, suggesting that disclosure may provide reassurance when genetic risk is absent. Awareness of genotype did not reliably affect objective cognition; however, exploratory analyses found that among ɛ4 carriers, awareness was associated with poorer working memory performance when it was assessed early in the test battery but better performance when assessed later. Together, these findings suggest that being aware of a heightened genetic risk for AD can undermine older adults' perceived cognitive control and, under certain conditions, produce transient adverse effects on working memory performance.