Predictors of positive or negative reactions to learning Alzheimer’s biomarker results

With improved detection of Alzheimer’s disease and biomarker accessibility, more adults with no or mild symptoms may learn their AD biomarker results. Yet, potential psychosocial impact of learning AD biomarkers is not well understood. In a phone survey, we assessed potential reactions after learning about a hypothetical positive AD biomarker result. Data were collected from cognitively healthy participants (n=334, mean age=64.8±7.7) enrolled in longitudinal AD studies. Exploratory factor analysis identified five latent factors following a hypothetical positive biomarker result: advanced care planning, lifestyle changes to reduce dementia risk factors, psychological distress, subjective cognitive complaints, and stigma. Using linear regression, we found that predictors of potential pessimistic reactions (distress, cognitive complaints, stigma) included higher trust in research (Distress:b:0.04, p:0.04), no dementia family history (Stigma:b:-0.30,p:0.04), poorer memory self-rating (Cognitive complaints:b:-0.19,p:0.02), and Black racial identity (Cognitive complaints:b:0.30,p:0.02, Stigma:b:0.40,p:0.003). Predictors of potential optimistic reactions (advanced care planning, lifestyle changes) included more trust in research (Planning:b:0.07,p<0.0001) and Black racial identity (Planning:b:0.38,p:0.003), as well as younger age (Lifestyle:b:-0.02,p:0.02) and belief in AD controllability (Planning:b:0.22,p:0.003, Lifestyle:b:0.23,p:0.002). Concern about developing AD was associated with increased likelihood of all potential reactions. While AD concern associates with optimistic and pessimistic potential reactions, specific factors of family history, racial identity, trust, belief in AD controllability, and memory rating differentially predict each of the potential outcomes of learning AD biomarker results. These findings may help target education efforts to prepare and reduce risk of negative reactions for cognitively healthy adults who learn their AD biomarker results.

Associations between PACS symptoms and risk factors among Long Haulers in the Rutgers Post-COVID Recovery Program

At least 2/3 of people with mild to moderate COVID-19 infection will experience long-haul COVID symptoms that persist for weeks or months, however, risk factors that modify the likelihood that one develops these symptoms are unknown. Patients referred to the Post-COVID Recovery Program at Rutgers in New Brunswick (n= 108) through primary care referral or self-submitted online request and experiencing a wide variety of Post-Acute COVID-19 Syndrome (PACS) symptoms were stratified by those without self-reported cognitive complaints (n=54), those with self-reported cognitive complaints who scored well on cognitive testing (n=29), and those with self-reported cognitive complaints who scored poorly on cognitive testing (n=25). Comparisons between groups were made using ANOVAs and Chi Squared: for COVID-19 disease severity, COVID-19 disease treatment, comorbid COVID-19 symptoms during infection, comorbid PACS symptoms post-infection, pre-existing health conditions, levels of depression and anxiety, level of fatigue, and social determinants of health (access to healthcare, economic stability, housing stability). Preliminary analyses indicated that whereas people without complaints were normally distributed according to age (p>0.200 for Kolmogorov–Smirnov test), people with complaints and deficits were skewed towards the older age group (p<0.001 for K-S test) suggesting age to be a risk factor for cognitive impairment in PACS. Participants that reported cognitive complaints also reported increased symptoms of depression, anxiety, and fatigue, compared to participants without cognitive complaints. These data provide insight into associations between PACS symptoms and risk factors relevant in understanding this novel disease.