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. 2024 Nov;20(11):7635-7656.
doi: 10.1002/alz.14226. Epub 2024 Oct 1.

Psychological outcomes of dementia risk estimation in MCI patients: Results from the PreDADQoL project

Ayda Rostamzadeh  1 , Franziska Kalthegener  1 , Carolin Schwegler  2   3 , Vanessa Romotzky  4 , Silvia Gil-Navarro  5 , Maitée Rosende-Roca  5   6 , Gemma Ortega  5 , Pilar Canabate  5 , Mariola Moreno  5 , Franziska Maier  1 , Philip Zeyen  1 , Ann-Katrin Schild  1 , Dix Meiberth  1 , Lena Sannemann  1 , Lara Bohr  1 , Björn Schmitz-Luhn  3 , Mercè Boada  5   6 , Christiane Woopen  3 , Frank Jessen  1   7   8
Affiliations

Psychological outcomes of dementia risk estimation in MCI patients: Results from the PreDADQoL project

Ayda Rostamzadeh et al. Alzheimers Dement. 2024 Nov.

Abstract

Introduction: Understanding the impact of biomarker-based dementia risk estimation in people with mild cognitive impairment (MCI) and their care partners is critical for patient care.

Methods: MCI patients and study partners were counseled on Alzheimer's disease (AD) biomarker and dementia risk was disclosed. Data on mood, quality of life (QoL), and satisfaction with life (SwL) were obtained 1 week and 3 months after disclosure.

Results: Seventy-five dyads were enrolled, and two-thirds of the patients opted for biomarker testing. None of the participants experienced clinically relevant depression or anxiety after disclosure. All dyads reported moderate to high QoL and SwL throughout the study. Patients reported more subthreshold depressive symptoms 1 week and lower QoL and SwL 3 months after disclosure. In patients, depression (odds ratio [OR]: 0.76) and anxiety (OR: 0.81) were significant predictors for the decision against biomarker testing.

Discussion: No major psychological harm is to be expected in MCI patients and care partners after dementia risk disclosure.

Trial registration: This study is registered in the German clinical trials register (Deutsches Register Klinischer Studien, DRKS): http://www.drks.de/DRKS00011155, DRKS registration number: DRKS00011155, date of registration: 18.08.2017.

Highlights: Patients with mild cognitive impairment (MCI) and study partners were counseled on Alzheimer's disease (AD) biomarker-based dementia risk estimation. About two-thirds of patients opted for biomarker testing and received their dementia risk based on their AD biomarker status. Patients who decided in favor or against CSF biomarker testing differed in psychological features. We did not observe major psychological harm after the dementia risk disclosure. Coping strategies were associated with better subsequent mood and well-being in all participants.

Keywords: Alzheimer's disease; anxiety; biomarker; close other; coping; counseling; dementia risk; depression; disclosure; mild cognitive impairment; quality of life; satisfaction with life.

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Conflict of interest statement

Ayda Rostamzadeh has received fees for presentations from Eisai. Franziska Maier has received fees from Ely Lilly and Johnson & Johnson. Mercè Boada has received fees from Grifols, Araclon Biotech, Roche, Biogen, Lilly, Merck, Zambon, Novo‐Nordisk, Roche, Biogen, Grifols, Nutricia, Araclon Biotech, Servier, and Novo‐Nordisk. Frank Jessen has received fees for advice or presentations from AC Immune, Biogen, Cogthera, Eisai, Eli Lilly, Grifols, Janssen, Novo Nordisk, and Roche. Franziska Kalthegener, Carolin Schwegler, Vanessa Romotzky, Silvia Gil‐Navarro, Maitée Rosende‐Roca, Gemma Ortega, Pilar Canabate, Mariola Moreno, Philip Zeyen, Ann‐Katrin Schild, Dix Meiberth, Lena Sannemann, Lara Bohr, Björn Schmitz‐Luhn, and Christiane Woopen have nothing to disclose. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Study flow chart. CSF, cerebrospinal fluid; MCI, mild cognitive impairment.
FIGURE 2
FIGURE 2
Outcomes over time in patients and study partners according to communicated dementia risk. Outcomes on depression, anxiety, QoL, SwL, and affective well‐being over time according to communicated dementia risk, adjusted for age and gender. Error bars show 95% CI. V1, Visit 1 (1‐week follow‐up); V2, Visit 2 (3‐month follow‐up). Risk Group 1: low to medium dementia risk group, with patients who did not consent to CSF biomarker testing and patients with normal biomarker status with their corresponding study partners. Risk Group 2: high dementia risk group, with patients having an abnormal biomarker status with their corresponding study partners. [correction added on October 4, 2024, after first online publication on October 1, 2024: Figure 2 has been updated.]
FIGURE 2
FIGURE 2
Outcomes over time in patients and study partners according to communicated dementia risk. Outcomes on depression, anxiety, QoL, SwL, and affective well‐being over time according to communicated dementia risk, adjusted for age and gender. Error bars show 95% CI. V1, Visit 1 (1‐week follow‐up); V2, Visit 2 (3‐month follow‐up). Risk Group 1: low to medium dementia risk group, with patients who did not consent to CSF biomarker testing and patients with normal biomarker status with their corresponding study partners. Risk Group 2: high dementia risk group, with patients having an abnormal biomarker status with their corresponding study partners. [correction added on October 4, 2024, after first online publication on October 1, 2024: Figure 2 has been updated.]
FIGURE 2
FIGURE 2
Outcomes over time in patients and study partners according to communicated dementia risk. Outcomes on depression, anxiety, QoL, SwL, and affective well‐being over time according to communicated dementia risk, adjusted for age and gender. Error bars show 95% CI. V1, Visit 1 (1‐week follow‐up); V2, Visit 2 (3‐month follow‐up). Risk Group 1: low to medium dementia risk group, with patients who did not consent to CSF biomarker testing and patients with normal biomarker status with their corresponding study partners. Risk Group 2: high dementia risk group, with patients having an abnormal biomarker status with their corresponding study partners. [correction added on October 4, 2024, after first online publication on October 1, 2024: Figure 2 has been updated.]
FIGURE 3
FIGURE 3
(A) Frequency of reported affective well‐being at baseline (before dementia risk disclosure), measured by the PANAS in patients deciding against CSF biomarker testing versus patients deciding in favor of CSF biomarker testing. The charts depict each single item of the positive and negative affect scale. Chi‐squared test or Fisher's exact test: *p < 0.05. (B) Frequency of reported affective well‐being at baseline (before dementia risk disclosure), measured by the PANAS in study partners of patients deciding against CSF biomarker testing versus study partners of patients deciding in favor of CSF biomarker testing. The charts depict each single item of the positive and negative affect scale. Chi‐squared test or Fisher's exact test: *p < 0.05.
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