Marina Ritchie, R. Raman, K. Ernstrom, S. Wang, M. C. Donohue, P. Aisen, D. Henley, G. Romano, G. P. Novak, H. R. Brashear, R. A. Sperling, J. D. Grill
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Grill","doi":"10.14283/jpad.2024.157","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.</p><h3 data-test=\"abstract-sub-heading\">Design, Setting, Participants</h3><p>We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p<0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p<0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=<0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"7 1","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Views and Perceptions of Amyloid Imaging in a Preclinical Alzheimer’s Disease Trial\",\"authors\":\"Marina Ritchie, R. 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引用次数: 0
摘要
背景许多认知功能未受损的老年人对了解自己的阿尔茨海默病(AD)生物标志物状态很感兴趣,但在临床前AD试验中,人们对接受生物标志物检测和结果披露的动机知之甚少。目的探讨与淀粉样蛋白未升高者相比,淀粉样蛋白升高者接受AD生物标志物检测和结果披露的动机是否不同,以及淀粉样蛋白结果披露是否会影响参与者的动机。作为试验筛选过程的一部分,参与者接受了生物标志物检测并进行了信息披露。我们分析了2241名参与者的数据。我们分析了淀粉样蛋白成像的观点和看法(VPAI)的数据,这是一份由9个项目组成的问卷,评估参与者对接受淀粉样蛋白检测的动机因素的认同程度。结果与淀粉样蛋白未升高组的参与者相比,淀粉样蛋白升高组的参与者在 "确认我可能已经出现了AD痴呆症的症状"(p<0.001)和 "让我的家人为我将来可能患病做好准备"(p=0.008)这两个最高认可度的项目上,在淀粉样蛋白升高组的参与者中所占的比例更大。披露后,未升高淀粉样蛋白组在 "让我安心"(OR:0.54;p<0.001)、"确认我可能已经出现 AD 痴呆症状"(OR:0.79;p=0.049)和 "让我的家人为我将来可能患病做好准备"(OR:0.结论研究者可以考虑调整未来试验的招募策略,以符合淀粉样蛋白升高参与者最强烈认可的生物标记物检测和信息披露动机。
Views and Perceptions of Amyloid Imaging in a Preclinical Alzheimer’s Disease Trial
Background
Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.
Objectives
Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.
Design, Setting, Participants
We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.
Measurements
We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.
Results
Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p<0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p<0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=<0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).
Conclusions
Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.
期刊介绍:
The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.