Alzheimer Disease Clinical Trial
Official title:
Risk Evaluation and Education for Alzheimer's Disease (REVEAL) II
The REVEAL II study provides healthy adult children and siblings of Alzheimer's disease patients with genetic testing and information about their own chances of developing the disease. The study will compare a condensed education and counseling program to the current more extensive program.
Alzheimer's disease (AD) is a common, progressive disease affecting memory and cognition.
Apolipoprotein E (APOE) has been identified as a genetic factor that may increase the risk
of developing Alzheimer's disease (AD). While several consensus statements have advised
against the clinical use of APOE genotyping, each of these called for research to evaluate
the impact of susceptibility genotyping and to explore the process of communicating about
risk issues. The REVEAL I Study was funded in 1999 to enroll adult children of patients with
AD to determine who would choose to obtain APOE genotyping, to devise an education and
counseling protocol for the disclosure of APOE genotyping, and to study the impact of
disclosing this information. The REVEAL I study demonstrated that Alzheimer's disease risk
assessments with APOE genotyping can be given to relatives of people with Alzheimer's
disease without causing severe adverse psychological or behavioral effects.
The REVEAL II study will examine whether receiving risk assessment and APOE genotyping
disclosure through a Condensed Education and Counseling Protocol is as safe and as effective
as receiving such information through our current Extended Protocol. This study will also
examine whether there are any differences among groups who receive disclosure of APOE
results and risk assessment by different provider types, such as a physician or a genetic
counselor. At least one-third of the participants in REVEAL II will be African American, in
order to explore how racial identity affects the desire to obtain genetic risk assessment
and the impact of receiving it.
Individuals who have a parent or sibling affected by Alzheimer's disease may enter the study
either by self-referral to the study coordinator or by recruitment. Participants will have a
scheduled phone interview during which demographic information, their relative's medical
history, attitudes toward genetic testing and risk assessment for Alzheimer's disease, and
interest in going on to the next step of the study will be assessed. During the second step
of the study, participants will be randomly assigned to one of three study arms.
Participants in the control arm of the study will be given the full educational and
counseling protocol as was originally developed in the first funding period of this study.
All participants will have the opportunity to continue with the study and have their blood
drawn for genotype analysis and risk assessment. Follow-up sessions will be provided with
psychometric measures and questionnaires.
Participants will be seen by the genetic counselor for two follow-up appointments, six weeks
and six months after disclosure of risk information. A final 12 month follow-up
questionnaire will be completed by mail and will be followed by a phone call from the
genetic counselor.
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