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P3‐489: Do not ask, do not tell: Infrequent help‐seeking for behavioral disturbances in cognitively impaired Latino elderly despite high need
Author(s) -
Hinton Ladson
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.2060
Subject(s) - help seeking , dementia , distress , depression (economics) , psychiatry , institutionalisation , psychology , medicine , clinical psychology , medical prescription , mental health , disease , pathology , economics , pharmacology , macroeconomics
(AD) patients were enrolled in the Risk Evaluation and Education for Alzheimer’s Disease (REVEAL) Study, an NIH-funded, multi-center randomized clinical trial providing APOE genotype-based risk assessments. Study participants read a list of commonly cited reasons for pursuing or declining genetic testing for AD risk such as, “the need to make arrangements for my long-term care,” and “the test results might upset my loved ones.” Participants ranked the importance of each item to them using a 5 point scale (1 not at all important to 5 extremely important). Mean perceived benefits was derived by averaging responses to 12 reasons for pursuing testing, and mean perceived risks was derived by averaging responses to 10 reasons for declining testing. Scores were assessed for 273 participants prior to an education and genetic counseling session (pre-ed) and again 12 months after a risk disclosure session. 1-sample t tests were performed on the changes in scores. Analyses were also run on subscales and individual items. Results: Mean perceived benefits remained high 12 months after risk disclosure although significantly lower than at pre-ed (3.17 vs 3.34, p .01). Analysis of individual items showed the sharpest drop on, “to seek information on preventive measures” (3.74 vs 4.26, p .01). Mean perceived risks remained low at 12 months and the change from pre-ed was not statistically significant (1.90 vs 1.84, p .09). However, a 3-item “fear of discrimination” subscale did have a significant increase at 12 months (2.08 vs 1.91, p .01). No effects were detected for gender, self-identified race, age, education, genotype or randomization status. Conclusions: Education, genetic counseling and genetic testing can change beliefs about the pros and cons of genetic susceptibility testing for AD. Beliefs about risk reduction and genetic discrimination appear particularly likely to change following this process. Further research needs to be conducted to explain why these changes occurred.