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. 2017 Sep;13(9):1024-1030.
doi: 10.1016/j.jalz.2017.01.022. Epub 2017 Mar 3.

Safety of disclosing amyloid status in cognitively normal older adults

Jeffrey M Burns  1 , David K Johnson  2 , Edward P Liebmann  3 , Rebecca J Bothwell  4 , Jill K Morris  4 , Eric D Vidoni  4
Affiliations

Safety of disclosing amyloid status in cognitively normal older adults

Jeffrey M Burns et al. Alzheimers Dement. 2017 Sep.

Abstract

Introduction: Disclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk.

Methods: We assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test-related distress after disclosure.

Results: Clinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test-related distress were present after disclosure and were related to greater baseline levels of anxiety and depression.

Discussion: Disclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre- and postdisclosure counseling has a low risk of psychological harm.

Keywords: Amyloid PET imaging; Anxiety; Biomedical ethics; Depression; Diagnostic imaging; Preclinical Alzheimer's disease; Safety; Truth disclosure.

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Figures

Figure 1
Figure 1. Anxiety and Depression Symptoms Before and After Disclosure
Data at baseline, immediately post-disclosure (day of disclosure), and 6-weeks and 6 months post disclosure on the Center for Epidemiologic Studies Depression (CES-D) scale (Panel A) and the Beck Anxiety Inventory (BAI; Panel B). There was no difference in depressive symptoms across groups over time. A minimal increase in anxiety symptoms was apparent immediately post-disclosure in the amyloid elevated group but was not sustained over time.
See this image and copyright information in PMC

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