Abstract
BackgroundIt is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer’s disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer’s disease, and examined how using such a test may impact advance care planning.MethodsA cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer’s disease (N = 874). Subjects were asked whether they would want to take a hypothetical free and definitive test predictive of future Alzheimer’s disease. Then, imagining they knew they would develop Alzheimer’s disease, subjects rated the chance of completing advance care planning activities from 0 to 100. We classified a score > 50 as being likely to complete that activity. We evaluated characteristics associated with willingness to take a test for Alzheimer’s disease, and how such a test would impact completing an advance directive and discussing health plans with loved ones.ResultsOverall, 75% (N = 648) of the sample would take a free and definitive test predictive of Alzheimer’s disease. Older adults willing to take the test had similar race and educational levels to those who would not, but were more likely to be ≤75 years old (odds ratio 0.71 (95% CI 0.53–0.94)). Imagining they knew they would develop Alzheimer’s, 81% would be likely to complete an advance directive, although only 15% had done so already.ConclusionsIn this nationally representative sample, 75% of older adults would take a free and definitive test predictive of Alzheimer’s disease. Many participants expressed intent to increase activities of advance care planning with this knowledge. This confirms high public interest in predictive testing for Alzheimer’s disease and suggests this may be an opportunity to engage patients in advance care planning discussions.
Highlights
It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer’s disease, or whether testing would change behavior
Even in the absence of highly effective treatment options, predictive tests for dementia may be useful to help patients and families prepare for decisions that need to Sheffrin et al Alzheimer's Research & Therapy (2016) 8:55 be made in the future, including advance care planning
Using data from a large, nationally representative sample, we explored who would take a hypothetical free and definitive test predictive of Alzheimer’s disease, and examined how use of such a test may impact advance care planning
Summary
It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer’s disease, or whether testing would change behavior. Even in the absence of highly effective treatment options, predictive tests for dementia may be useful to help patients and families prepare for decisions that need to Sheffrin et al Alzheimer's Research & Therapy (2016) 8:55 be made in the future, including advance care planning. Individuals may wish to prepare their family for the diagnosis of Alzheimer’s disease and cognitive decline, prepare financially, or complete advance directives [7]. This may be an opportunity to engage patients in advance care planning at a time when they are already contemplating their future health, before the onset of cognitive impairment. Even in the absence of a cure or treatment, testing can help individuals prepare themselves and their families for care decisions in the future
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