Technology and Dementia Preconference.

Area of Science:

• Genetics
• Neuroscience
• Clinical Trials

Background:

• APOE genotyping is crucial for Alzheimer's prevention trials and guiding anti-amyloid treatment decisions.
• APOE4 carriers face higher risks for treatment side effects, necessitating clear communication protocols.
• Evidence-based practices for sharing APOE results are needed to support clinical decision-making.

Purpose of the Study:

• To compare the effectiveness of telephone disclosure (TD) versus videoconference disclosure (VD) of APOE4 genotype results.
• To assess patient-reported outcomes (PROs), including genetic knowledge, disease-specific distress, and satisfaction.
• To evaluate potential differences in outcomes based on APOE genotype and participant demographics.

Main Methods:

• A multi-center, randomized trial (CONNECT4) involving cognitively unimpaired adults aged 60-75.
• Participants were randomized to receive APOE4 disclosure via TD or VD with a genetic counselor.
• PROs were collected at multiple time points post-disclosure; T-tests and Fisher's exact tests were used for comparisons.

Main Results:

• No significant differences in genetic knowledge or distress were observed between TD and VD arms.
• Overall satisfaction was slightly higher with TD.
• Subgroup analyses revealed differences in perceived risk among homozygotes and noncarriers, and reduced state anxiety with VD for non-White participants.

Conclusions:

• Both TD and VD are viable methods for disclosing APOE results to cognitively unimpaired individuals.
• Videoconference may offer specific advantages for certain subgroups, including potential anxiety reduction for non-White participants.
• These findings support flexible approaches to genetic counseling and result disclosure based on individual needs and preferences.