title: Safety of disclosing amyloid status in cognitively normal older adults.
abstract: BACKGROUND
  Disclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk.
  
  
  METHODS
  We assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test-related distress after disclosure.
  
  
  RESULTS
  Clinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test-related distress were present after disclosure and were related to greater baseline levels of anxiety and depression.
  
  
  CONCLUSIONS
  Disclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre- and postdisclosure counseling has a low risk of psychological harm.
authors.affiliation: Department of Neurology, University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: jburns2@kumc.edu.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Burns
authors.affiliation: Department of Neurology, University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA; Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: David K
authors.initials: DK
authors.lastname: Johnson
authors.affiliation: Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Liebmann
authors.affiliation: Department of Neurology, University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Bothwell
authors.affiliation: Department of Neurology, University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Morris
authors.affiliation: Department of Neurology, University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Vidoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000378:metabolism*; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000378:metabolism / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D030881:Disclosure; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D017063:Outcome Assessment, Health Care; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests
chemical_list: D000682:Amyloid
keywords: Amyloid PET imaging; Anxiety; Biomedical ethics; Depression; Diagnostic imaging; Preclinical Alzheimer's disease; Safety; Truth disclosure