Genetic susceptibility testing versus family history–based risk assessment: Impact on perceived risk of Alzheimer disease
Open accessAbstract
Purpose We examined how an Alzheimer disease (AD) family history assessment as compared to a risk assessment incorporating the absence of a disease-associated susceptibility allele affected risk perception among adult children with a family history of AD. Methods The REVEAL study is a clinical trial in which adult children of patients with AD were randomized to receive a risk assessment based upon family history alone or family history plus apolipoprotein E (APOE) disclosure. In this analysis, two subsets of women were identified, each of whom received identical 29% lifetime risk estimates of developing AD. One group received a risk estimate that incorporated APOE epsilon4-negative genetic test results (Genotype Group, n = 30), whereas the other received a risk estimate based on family history and gender (Family History Group, n = 36). Six weeks after risk disclosure, we surveyed participants regarding the impact of the risk assessment on their perceptions of AD risk. Results 73% of the Genotype Group judged their risk to be lower compared to 25% of the Family History Group (P < 0.0001). 67% of the Genotype Group reported lower anxiety about AD, versus 26% of the Family History Group (P < 0.01). 80% of the Genotype Group indicated that the risk information had a positive impact, versus 36% of the Family History Group (P < 0.001). The Genotype Group was less likely to believe that they would develop AD (13% vs. 36%, P < 0.05) and was more likely to report that the risk assessment removed uncertainty about their chances of developing AD (63% vs. 9%, P < 0.0001). Conclusions These data suggest that risk estimates incorporating negative genetic test results affect perceptions of disease susceptibility more strongly than identical estimates based on family history alone.
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Studies on genetic susceptibility testing for Alzheimer's disease show a strong association between family history and genetic risk factors and self-perceived risk of the disease.
“Similarly, studies on genetic susceptibility testing for AD have shown that there is a strong association between family history and genetic risk factor for AD on self-perceived risk of the disease (Hiraki, Chen, Roberts, Cupples, & Green, 2008; Larusse et al., 2005).”
From Correlates of dementia-related anxiety: self-perceived dementia risk and ageism (2020) · cites this paper as Larusse et al., 2005
The Abstract (page unavailable) reports that women given an APOE ε4-negative result perceived lower AD risk than women given the same numerical estimate based on family history alone. This supports an effect of genetic-test information on perceived risk, but all participants had a family history of AD; the study does not establish a separate strong association between family history and perceived risk. (LLM, conf=0.86)
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Langbaum, J. B. S., Erickson, C. M., Langlois, C. M., Wood, E. M., Egleston, B. L., Harkins, K. A., Mim, R., John, S., Brown, C., Brown, S., et al. (2026) · medRxiv · doi:10.64898/2026.08.27.26361535
Self-citation
- Authors
- Larusse, S., Roberts, J. S., Marteau, T. M., Katzen, H., Linnenbringer, E. L., Barber, M., Whitehouse, P., Quaid, K., Brown, T., Green, R. C., & Relkin, N. R.
- Affiliations
- Columbia University (US)
- Boston University (US)
- King's College London (GB)
- Cornell University (US)
- University Hospitals of Cleveland (US)
- ORCID
- Venue
- Genetics in Medicine
- Publisher
- Elsevier BV
- Published
- 2005-01
- Volume
- 7
- Issue
- 1
- Pages
- 48-53
- ISSN
- 1098-3600 (ISSN-L)
- OpenAlex
- W2134881136
- Cited by
- 67
- References
- 27
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 2 · 2016: 2 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 7
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Genetics in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- National Institute on Aging (P30AG013846)
- National Human Genome Research Institute (R01-HG/AG02213)
- National Center for Research Resources (M01RR000533)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- Alzheimer's disease, genetic susceptibility testing, family history (medicine), risk perception, apolipoprotein E, APOE ε4, risk disclosure, anxiety, uncertainty reduction, risk communication
- MeSH terms
- Alzheimer Disease, Apolipoproteins E, Family, Genetic Testing, Genotype, Humans, Pedigree, Risk Factors, Risk Assessment, Genetic Predisposition to Disease
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