title: Comparing knowledge and attitudes towards genetic testing in Parkinson's disease in an American and Asian population.
abstract: BACKGROUND
  Recent discoveries of disease-causing genes in Parkinson's disease (PD) have generated considerable interest regarding genetic testing in PD. The attitudes toward genetic testing are largely influenced by knowledge and preconceived notions.
  
  
  OBJECTIVE
  We investigated the relationship between knowledge of and attitude towards predictive genetic testing of PD in two independent centers in America and Asia involving PD patients and caregivers.
  
  
  METHODS
  In a prospective study involving 515 subjects comprising of PD patients and their caregivers in two independent centers in America and Asia, the level of knowledge about genetic testing and patients' attitudes towards such testing were evaluated using a standardized questionnaire.
  
  
  RESULTS
  American PD patients had a higher level of knowledge of PD genetics than Asian PD (31.1% vs. 12.3%, p=0.0002). A greater number of American PD patients and caregivers reported a positive attitude towards the potential medical benefits of genetic testing compared to their Asian counterparts (85.4% vs. 42.2%, 92.2% vs. 32.1%, p<0.00005), but a more negative attitude towards potential compromise in getting health and life insurance (43.7% vs. 25.8%, p=0.0002). However, in the Asian cohort, multivariate analysis revealed that a high level of genetics knowledge was associated with a positive attitude response regarding the potential medical benefits of testing (p<0.0005), but a negative attitude towards compromises in healthcare and life insurance, getting a job and starting a family (p<0.0005). These associations were not observed amongst American subjects.
  
  
  CONCLUSIONS
  The relationship between level of genetic knowledge and attitude towards potential risks and benefits of predictive genetic testing in PD was distinctly different in two independent, racially and culturally different PD populations and caregivers. These observations have clinical implications in the development of PD genetic counseling programs.
authors.affiliation: Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. gnrtek@sgh.com.sg
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
authors.forename: Jennie
authors.initials: J
authors.lastname: Lee
authors.forename: Christine
authors.initials: C
authors.lastname: Hunter
authors.forename: Lina
authors.initials: L
authors.lastname: Shinawi
authors.forename: S
authors.initials: S
authors.lastname: Fook-Chong
authors.forename: Joseph
authors.initials: J
authors.lastname: Jankovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology*; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D005260:Female; D005820:Genetic Testing / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000175:diagnosis* / Q000208:ethnology* / Q000235:genetics; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014481:United States / Q000453:epidemiology