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Rosen AC, Arias JJ, Ashford JW, Blacker D, Chhatwal JP, Chin NA, Clark L, Denny SS, Goldman JS, Gleason CE, Grill JD, Heidebrink JL, Henderson VW, Lavacot JA, Lingler JH, Menon M, Nosheny RL, Oliveira FF, Parker MW, Rahman-Filipiak A, Revoori A, Rumbaugh MC, Sanchez DL, Schindler SE, Schwarz CG, Toy L, Tyrone J, Walter S, Wang LS, Wijsman EM, Zallen DT, Aggarwal NT. The Advisory Group on Risk Evidence Education for Dementia: Multidisciplinary and Open to All. J Alzheimers Dis 2022; 90:953-962. [PMID: 35938255 PMCID: PMC9901285 DOI: 10.3233/jad-220458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The brain changes of Alzheimer's disease and other degenerative dementias begin long before cognitive dysfunction develops, and in people with subtle cognitive complaints, clinicians often struggle to predict who will develop dementia. The public increasingly sees benefits to accessing dementia risk evidence (DRE) such as biomarkers, predictive algorithms, and genetic information, particularly as this information moves from research to demonstrated usefulness in guiding diagnosis and clinical management. For example, the knowledge that one has high levels of amyloid in the brain may lead one to seek amyloid reducing medications, plan for disability, or engage in health promoting behaviors to fight cognitive decline. Researchers often hesitate to share DRE data, either because they are insufficiently validated or reliable for use in individuals, or there are concerns about assuring responsible use and ensuring adequate understanding of potential problems when one's biomarker status is known. Concerns include warning people receiving DRE about situations in which they might be compelled to disclose their risk status potentially leading to discrimination or stigma. The Advisory Group on Risk Evidence Education for Dementia (AGREEDementia) welcomes all concerned with how best to share and use DRE. Supporting understanding in clinicians, stakeholders, and people with or at risk for dementia and clearly delineating risks, benefits, and gaps in knowledge is vital. This brief overview describes elements that made this group effective as a model for other health conditions where there is interest in unfettered collaboration to discuss diagnostic uncertainty and the appropriate use and communication of health-related risk information.
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Affiliation(s)
- Allyson C. Rosen
- VA Medical Center-Palo Alto, Palo Alto, CA, USA,Stanford University, School of Medicine, Stanford, CA, USA,Correspondence to: Allyson C. Rosen, PhD, ABPP-CN, Mental Illness Research, Education and Clinical Center (MIRECC), Palo Alto VA Medical Center, 3801 Miranda Ave (151Y), Palo Alto, CA 94304-1207, USA. Tel.: +1 650 279 3949;
| | - Jalayne J. Arias
- School of Public Health Georgia State University, Atlanta, GA, USA
| | - J. Wesson Ashford
- VA Medical Center-Palo Alto, Palo Alto, CA, USA,Stanford University, School of Medicine, Stanford, CA, USA
| | - Deborah Blacker
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Nathan A. Chin
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lindsay Clark
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sharon S. Denny
- The Association for Frontotemporal Degeneration, King of Prussia, PA, USA
| | - Jill S. Goldman
- Columbia University Irving Medical Center, New York, NY, USA
| | - Carey E. Gleason
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Judith L. Heidebrink
- Michigan Alzheimer’s Disease Research Center, University of Michigan, Ann Arbor, MI, USA
| | - Victor W. Henderson
- Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA
| | | | | | | | - Rachel L. Nosheny
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | | | - Monica W. Parker
- Emory Goizueta Alzheimer’s Disease Research Center, Atlanta, GA, USA
| | | | | | | | | | - Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | | | - Leslie Toy
- VA Medical Center-Palo Alto, Palo Alto, CA, USA
| | - Jamie Tyrone
- Beating Alzheimer’s by Embracing Science, Ramona, CA, USA
| | - Sarah Walter
- Alzheimer’s Therapeutic Research Institute/USC, San Diego, CA, USA
| | - Li-san Wang
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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