BACKGROUND

Advances in Alzheimer's Disease (AD) biomarker studies have been promising.  Despite this, there remains a relative dearth of dementia biomarker studies which include sizable numbers of ethnoracialized (e.g., African-Americans (AA), American Indian/Alaska Native (AI/AN), and Latinx (LTX) samples. Efforts to help mitigate this research disparity include investigating how and whether ethnoracialized groups differ in their willingness to engage in preclinical AD biomarker studies. We improve upon extend knowledge in this area by including community-based participants, utilizing quantitative methods, and larger numbers of racialized participants.

METHODS

We administered an online questionnaire to 1825 community-derived adults and assessed demographic characteristics as well as participants' views on dementia, research, and genetic  and biomarker testing. We examined factors hypothesized to increase community participants' willingness to undergo preclinical AD biomarker testing (see Figure ): self-reported gender, positive family history of dementia, education level, attitudes toward research (as measured by total RAQ score), attitudes toward prenatal genetic testing, and preventive and proactive health behavior engagement.  We tested our conceptual model using structural equation modeling (SEM; SPSS AMOS).

 

RESULTS

The sample included: NHW (n=725), AA (n = 599), AI/AN (n = 352), and LTX (n = 149) participants. The unconstrained (configural) model demonstrated good overall fit to the data, χ²(24) = 56.18, p < .001, χ²/df = 2.34, RMSEA = 0.027 (90% CI [.018, .036]), CFI = 0.969.  However, the constrained model and  nested chi-square difference test indicated that there was not structural invariance, i.e., the strength of the relationships between the variables and outcome variable (willingness to engage in testing) varied according by group.  Therefore, we examined the hypothesized model in each group separately.  The Table provides the results of the  SEM (standardized coefficients) for each group. Attitudes toward research was the sole factor that had a direct effect  on biomarker testing willingness across all the groups.

CONCLUSIONS

While research attitudes appear to play a large role in influencing willingness to engage in preclinical AD biomarker testing, willingness to  undergo prenatal genetic testing also appears to exert an effect.  Implications of these findings for community-based outreach and engagement for biomarker studies will be discussed.