Abstract
INTRODUCTION
The long-term implications of disclosing Alzheimer’s disease (AD) biomarker information to cognitively unimpaired individuals are unknown.
METHODS
We compared participants who disclosed their elevated amyloid imaging result in a preclinical AD trial to those who disclosed a not elevated result and enrolled in an observational cohort that underwent parallel assessments. Our primary outcome was a score > 0 on the Columbia Suicidality Severity Rating Scale (CSSRS) at any visit; we also considered suicidal behaviors (CSSRS > 5).
RESULTS
Among 1707 total participants (68% elevated amyloid, mean [standard deviation] age 71.5 [4.7], 60% female, 90% non-Hispanic White), followed for a mean 218 (74.1) weeks, there were no suicides and few indications of suicidal thoughts (n = 124 [7%]) or behaviors (n = 13 [<1%]). In a generalized estimating equation model controlling for covariates, we observed no effect of amyloid status on the primary outcome of CSSRS > 0 (odds ratio = 1.6, 95% confidence interval = 0.76, 3.37).
DISCUSSION
With a structured approach, brain amyloid results can be returned safely.
Highlights
The Anti-Amyloid Treatment in Asymptomatic Alzheimer’s study was among the first and largest studies to include biomarker disclosure in a population without cognitive impairment.
Routine psychological assessment provided a novel assessment of the impact of disclosure in this sample.
Learning an elevated brain amyloid result through a protocolized approach was not associated with suicidal thoughts or behaviors compared to a matched cohort who learned they did not have elevated brain amyloid.
Future research will be needed to ensure similar safety in more real-world settings.
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This post is Copyright: Joshua D. Grill,
Rema Raman,
Charlene Flournoy,
Karin Ernstrom,
Aimee Pierce,
Amanda Smith,
Paul Rosenberg,
Jeffrey Burns,
Jason Karlawish,
Paul Aisen,
Karen Chilcott Holdridge,
Michele Mancini,
Reisa Sperling,
David Sultzer,
for the A4 Study Team | February 24, 2025