title: Attitudes to Alzheimer's disease testing of Australian general practice patients: a cross-sectional questionnaire-based study.
abstract: OBJECTIVE
  In view of proposed screening for presymptomatic Alzheimer's disease (AD) with advanced imaging, and blood and cerebral spinal fluid analysis, we aimed to establish levels, and associations, of acceptance of AD testing modalities by general practice patients.
  
  
  METHODS
  A cross-sectional questionnaire-based study of consecutive patients (aged 50 years and over) of general practices of an Australian practice-based research network was used. The questionnaire elicited demographic data and attitudes to screening for other diseases and included the screening acceptance domain of the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) instrument. This assesses receptivity to modalities of testing for AD: short questionnaire, blood test, cerebral imaging, and annual physician examination. Reflecting speculation of possible future AD diagnostic methods, an item regarding testing cerebral spinal fluid was also included. Associations of PRISM-PC scores were analyzed with multiple linear regression.
  
  
  RESULTS
  Of 489 participants (response rate 87%), 66.2% would like to know if they had AD. Participants were more accepting of testing modalities that were noninvasive or familiar (questionnaire, physician's examination, and blood test) as opposed to cerebral imaging or lumbar puncture. Attitudes to AD testing are influenced by a positive attitude to disease screening in general. Patients with a self-perceived higher risk of AD were less accepting of testing, as were participants with an educational level of junior high school (10 school years) or less.
  
  
  CONCLUSIONS
  This study demonstrates that a majority of patients would like to know if they have AD. Acceptability of testing modalities, however, varies. Noninvasive, familiar methods are more acceptable.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.|General Practice Training Valley to Coast, New South Wales, Australia.
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Juratowitch
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Dunbabin
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McElduff
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Goode
authors.affiliation: General Practice Training Valley to Coast, New South Wales, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Tapley
authors.affiliation: School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
authors.forename: Dimity
authors.initials: D
authors.lastname: Pond
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D001294:Attitude to Health; D001315:Australia; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012044:Regression Analysis; D011795:Surveys and Questionnaires
keywords: Alzheimer's disease; attitude to health; dementia; early diagnosis; general practice; invasive testing