Can seniors handle results of Alzheimer’s risk tests?
As researchers hone in on ways to detect whether someone has a high risk of developing Alzheimer’s disease before they have any symptoms, mental health professionals have worried what the psychological fallout of that knowledge might be.
But new research suggests that people can handle the truth.
In the study, seniors who didn’t have any Alzheimer’s symptoms underwent a special type of imaging scan to see if they had amyloid plaque deposits in their brains. The presence of these plaques means someone has a much higher risk of developing the memory-robbing condition.
A month or two after learning that they had these deposits, the seniors in the study who got the bad news appeared to be handling the information well.
“The study was an observational study to see if telling people whether they had elevated amyloid in the brain was a safe process,” explained study author Joshua Grill, director of the Institute for Memory Impairments and Neurological Disorders at the University of California, Irvine.
“In the short term, telling people that they have higher amyloid levels didn’t cause depression or suicidality,” Grill noted.
Researchers are trying to find ways to detect Alzheimer’s well before people show symptoms. This will hopefully lead to new avenues for treatment and prevention of the disease, according to background information in the study.
The research included more than 1,700 people aged 65 to 85 who were participating in a study to detect elevated levels of amyloid plaques before anyone had symptoms of Alzheimer’s disease. When these plaques clump together, they may interfere with communication between brains cells, according to the Alzheimer’s Association. But not everyone with amyloid plaque deposits will develop Alzheimer’s disease, Grill said.
All participants underwent positron emission scanning (PET scans). They were then told what their results were—almost 1,200 had elevated amyloid, more than 500 did not.
Grill said it’s important that the information come from people who are trained to deliver this type of news. “We have to share this information in a safe way, explaining what we understand and what we don’t yet know about elevated amyloid and the increased risk of the coming years.”
A month or two after getting their results, the study volunteers came back to complete a number of psychological tests.
There were no significant increases in depression, anxiety or suicidal thinking between the groups with and without extra amyloid.
Grill said further research needs to be done to see if younger or more diverse populations would have similar results. The average age in this study was nearly 72, and 95% were white.
Keith Fargo, director of scientific programs and outreach for the Alzheimer’s Association, said that tests looking for early signs of Alzheimer’s risk will be increasingly important for research, diagnosis and medical treatment of Alzheimer’s disease.
“However, with the rise of new biomarker tools, there comes an ethical obligation to ensure that testing does not cause harm. For example, there is the possibility that revealing the results of biomarker testing to individuals in research and clinical settings may cause serious distress,” he noted.
“Fortunately, it seems from this and similar studies that Alzheimer’s testing results that match with people’s expectations and day-to-day health realities may not necessarily provoke unexpectedly high levels of anxiety or depression. In fact, the largest effects were consistent with a feeling of relief in those who tested negative,” Fargo said.
“However, as the study authors note, we still need research that tracks representative study populations who receive these test results over the long term,” he added.
Both experts said it’s important for people to discuss thoroughly any test that predicts an increased risk of Alzheimer’s disease with their health care provider.
The findings were published Aug. 10 in the journal JAMA Neurology.