Skip to main content
Log in

Emotional Responses to APO E Genotype Disclosure for Alzheimer Disease

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

The purpose of our study is to assess the emotional responses to disclosing APO E genotype to asymptomatic older adults at increased risk for Alzheimer disease (AD). This is a longitudinal cohort study of volunteer subjects who were aged 50 years or over, asymptomatic for (AD), had a family history of AD, passed a psychological assessment, and participated in pre- and post-test genetic counseling and three follow-up visits over 10 months. We analyzed responses by three emotional constructs: depressed, worried, and relieved. Three hundred and twenty-eight subjects were screened, 76 received their APO E genotype. When emotional responses occurred it was immediate, between baseline and the 1 month follow-up. Emotional reactions did not change significantly past 1 month. Our results suggest that for emotionally stable persons, disclosing results of their APO E genotype, high risk subjects did not report more depression or worry and low risk subjects felt relieved by knowing the results. Future studies should evaluate the risks of disclosure to family members involved in the diagnostic work-up of a relative and include subjects from a broader range of emotional stability and socioeconomic background.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • ADRDA. (1987). National program to conquer Alzheimer’s disease. Chicago, IL: Alzheimer Disease and Related Disorders Association.

    Google Scholar 

  • Bird, T. D. (1995). Apolipoprotein E genotyping in the diagnosis of Alzheimer’s disease: A cautionary view. Ann Neurol, 38, 2–3.

    Article  CAS  PubMed  Google Scholar 

  • Corder, E. H., Saunders, A. M., Strittmatter, W. J., et al. (1993). Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families. Science, 261, 921–923.

    CAS  PubMed  Google Scholar 

  • Corder, E. H., Saunders, A. M., Risch, N. J., et al. (1994). Protective effect of apolipoprotein type 2 allele for late onsetalzheimer disease. Nat Genet, 7, 180–84.

    CAS  PubMed  Google Scholar 

  • Croyle, R. T., Smith, K. R., Botkin, J. R., et al. (1997). Psychological responses to BRCA1 mutation testing: Preliminary findings. Health Psychol, 16, 63–72.

    Article  CAS  PubMed  Google Scholar 

  • Evans, D. A., Scherr, P. A., Cook, N. R., et al. (1990). Estimated prevalence of Alzheimer’s disease in the United States. Milbank Q, 68, 267–289.

    CAS  PubMed  Google Scholar 

  • Farrer, L. A., Brin, M. F., Elsas, L., et al. (1995). Statement on use of apolipoprotein E testing for Alzheimer disease. American college of medical genetics/american society of human genetics working group on APO E and Alzheimer disease. JAMA, 274, 1627–1629.

    Article  PubMed  Google Scholar 

  • Farrer, L. A., Cupples, L. A., Haines, J. L., et al. (1997). Effects of age, sex, ethnicity on the association between apolipoprotein E genotype and Alzheimer disease: A meta-analysis. APO E and Alzheimer Disease Meta Analysis Consortium. JAMA, 278 (16), 349–56.

    Article  Google Scholar 

  • Fisher, L. D., & van Belle, G. (1993). Biostatistics a methodology for the health sciences. New York: Wiley, p. 210.

    Google Scholar 

  • Folstein, M. F., Folstein, Se., & McHugh, P. R. (1975). Mini-Mental State A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 12, 189–198.

    Article  CAS  PubMed  Google Scholar 

  • Hixson, J. E., & Vernier, D. T. (1990). Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with Hhal. J Lipid Res, 31, 545–548.

    CAS  PubMed  Google Scholar 

  • Holtzman, N. A., & Watson, M. S. (1997). Promoting safe and effective genetic testing in the United States: Final report of the task force on genetic testing. (National Institute of Health, Washington, DC).

  • Lerman, C., Narod, S., Schulman, K., et al. (1996). BRCA1 testing in families with hereditary breast-ovarian cancer: A prospective study of patients’ decision making and outcomes. JAMA, 272, 1885–1892.

    Article  Google Scholar 

  • Lynch, H. T., Watson, P., & Conway, T. A. (1993). DNA screening for breast/ovarian cancer susceptibility on linked markers: A family study. Arch Int Med, 53, 1979–1987.

    Article  Google Scholar 

  • Medical and Scientific Advisory Committee, and Alzheimer’s Disease International. (1995). Consensus statement on predictive testing for Alzheimer disease. Alzheimer Dis Assoc Disord 9, 182–187.

    Google Scholar 

  • Montano, C. B. (1994). Recognition of depression in a primary care setting. J Clin Psychiatry, 55(1, Suppl), 18–34.

    Google Scholar 

  • Nyenhuis, D. L., Yamamoto, C., Luchetta, T., et al. (1999). Adult and geriatric normative data and validation of the profile of mood states. J Clin Psychol, 55(1), 79–86.

    Article  CAS  PubMed  Google Scholar 

  • Post, S. G. (1996). On not jumping the gun: Ethical aspects of APO E gene testing for Alzheimer’s disease. Ann NY Acad Sci., 802, 111–119.

    CAS  Google Scholar 

  • Roberts, J. S., LaRusse, S. A., Katzen, H., et al. (2003). Reasons for seeking genetic susceptibility testing among first-degree relatives of people with Alzheimer disease. Alzheimer Dis Assoc Disord, 17(2), 86–93.

    Article  PubMed  Google Scholar 

  • Roses, A. D. (1996). Apolipoprotein E and Alzheimer’s disease: A rapidly expanding field with medical and epidemiological consequences. Ann NY Acad Sci, 802, 50–57.

    CAS  PubMed  Google Scholar 

  • Saunders, A. M., Hulette, C., Welsh-Bohmer, K. A., et al. (1996). Specificity, sensitivity, and predictive value of apolipoprotein E genotyping for sporadic Alzheimer’s disease. Lancet, 348, 90–93.

    Article  CAS  PubMed  Google Scholar 

  • Strittmatter, W. J., Saunders, A. M., Schmechel, D., et al. (1993). Apolipoprotein E: High-avidity binding to B-amyloid and increased frequence of type 4 allele in late-onset family Alzheimer disease. Proc Natl Acad Sci, 90, 1977–1981.

    CAS  PubMed  Google Scholar 

  • Whooley, M. A., Avins, A. L., Miranda, J., & Browner, W. S. (1997). Case finding instruments for depression: Two questions are as good as many. J Gen Intern Med, 12, 439–445.

    Article  CAS  PubMed  Google Scholar 

  • Wiggins, S., Whyte, P., Huggins, M., et al. (1992). The psychological consequences of predictive testing for Huntington’s disease. NEJM, 327, 1401–1405.

    CAS  PubMed  Google Scholar 

  • Yesavage, J. A., & Brink, T. L. (1983). Development and validation of a geriatric scale: A preliminary report. J Psychiatr Res, 17, 37–49.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Linda J. Romero.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Romero, L.J., Garry, P.J., Schuyler, M. et al. Emotional Responses to APO E Genotype Disclosure for Alzheimer Disease. J Genet Counsel 14, 141–150 (2005). https://doi.org/10.1007/s10897-005-4063-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10897-005-4063-1

Key words

Navigation