Exploring immediate responses to APOE ε 4/ε4 genotype and Alzheimer's disease risk disclosure in Latinos
Daniela Diaz Caro, Sophia Rodriguez, Wendy R. Uhlmann, Jill S. Goldman, Sarah McCain, John Brandon Wetmore, Maria L. Caban, Wendy K. Chung et al.. Journal of Alzheimer s Disease, 2026-03-30
Topic: Amyloid, tau and blood-test diagnosis
Background Few studies have investigated the psychosocial impact of APOE ε4/ε4 genotype disclosure, and none in ethnic minorities. Objective We used mixed methods to investigate immediate responses to APOE ε4/ε4 genotype disclosure among Latino residents of northern Manhattan who participated in the Información de la Enfermedad de Alzheimer para Latinos (IDEAL) Study. Methods Eleven ε4 homozygotes received their genotype and a 55% risk estimate for developing Alzheimer's disease (AD) by age 85 from bilingual genetic counselors. Session recordings were transcribed and qualitative content analysis performed. One week after disclosure, distress levels were assessed through the intrusion subscale of the Impact of Event Scale-Revised (IES-R) and five items from the Impact of Genetic Testing in AD scale (IGT-AD) for 7/11 homozygotes, compared with participants with 0 (n = 61) or 1 (n = 47) ε4 alleles who also learned their APOE genotypes. Results Nine homozygotes were women; seven had an AD family history; age averaged 51 years. Participants with an AD family history or memory worries felt their concerns were validated; others were often surprised. Only one participant showed signs of elevated psychological distress. Responses on the IES-R intrusion subscale and IGT-AD items differed significantly from those of IDEAL participants who learned they had 0 or 1 ε4 alleles, but distress levels were low. Conclusions Among most Latinos in northern Manhattan who learned they had an APOE ε4/ε4 genotype, disclosure did not provoke elevated levels of distress.
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APA 7th
Caro, D. D., Rodriguez, S., Uhlmann, W. R., Goldman, J. S., McCain, S., Wetmore, J. B., et al. (2026). Exploring immediate responses to APOE ε 4/ε4 genotype and Alzheimer's disease risk disclosure in Latinos. Journal of Alzheimer s Disease. https://doi.org/10.1177/13872877261435633
Vancouver
Caro DD, Rodriguez S, Uhlmann WR, Goldman JS, McCain S, Wetmore JB, et al. Exploring immediate responses to APOE ε 4/ε4 genotype and Alzheimer's disease risk disclosure in Latinos. Journal of Alzheimer s Disease. 2026. doi:10.1177/13872877261435633. PMID: 41906765.
BibTeX
@article{caro2026-41906765,
author = {Caro, Daniela Diaz and Rodriguez, Sophia and Uhlmann, Wendy R. and Goldman, Jill S. and McCain, Sarah and Wetmore, John Brandon and Caban, Maria L. and Chung, Wendy K. and others},
title = {{Exploring immediate responses to APOE ε 4/ε4 genotype and Alzheimer's disease risk disclosure in Latinos}},
journal = {Journal of Alzheimer s Disease},
year = {2026},
doi = {10.1177/13872877261435633},
pmid = {41906765},
url = {https://doi.org/10.1177/13872877261435633}
}
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Key findings
- One week after disclosure, distress levels were assessed through the intrusion subscale of the Impact of Event Scale-Revised (IES-R) and five items from the Impact of Genetic Testing in AD scale (IGT-AD) for 7/11 homozygotes, compared with participants with 0 (n = 61) or 1 (n = 47) ε4 alleles who also learned their APOE genotypes.ResultsNine homozygotes were women; seven had an AD family history; age averaged 51 years.
- Results Nine homozygotes were women; seven had an AD family history; age averaged 51 years.
- Responses on the IES-R intrusion subscale and IGT-AD items differed significantly from those of IDEAL participants who learned they had 0 or 1 ε4 alleles, but distress levels were low.
Why it matters
This small mixed-methods study of 11 Latino APOE ε4/ε4 homozygotes found that only one participant showed signs of elevated psychological distress after learning their genotype and risk estimate. It concerns the psychosocial impact of risk disclosure and reports no treatment, cure, or prevention findings.
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Study details
- Participants61
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer s Disease) |
| Journal's citation record | 2 / 4 | Journal of Alzheimer s Disease: journal h-index 218 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 61 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 4.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Ruth Ottman: h-index 74 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41906765) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
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