# Behavioral Change Following Culturally-Informed Biomarker Disclosure in Alzheimer’s Disease

> **NIH NIH K23** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $184,415

## Abstract

Project Summary
Alzheimer’s Disease (AD) and Dementia-Alzheimer’s Type (DAT) prevalence is growing among older adults,
and disproportionately so in Black seniors. Scientific advances have allowed for detection of protein
biomarkers associated with AD and increased risk for DAT. Both cognitively healthy and symptomatic older
adults are interested in their personalized PET amyloid and tau information. However, biomarker disclosure
rarely occurs in either clinical or research settings, in part due to concerns about how patients will react to and
use this information in the absence of validated treatments for DAT. While several studies have supported the
safety of positron emission tomography (PET) amyloid disclosure in regards to psychological reactions, very
few have examined actual behavior following risk feedback, and no studies have examined a prolonged
timeline of behavior change. The therapeutic effect of health behavior and lifestyle change on cognition and
functioning is well-established; however, whether disclosure may precipitate health-related change is unknown.
Furthermore, no study to date has investigated tau disclosure. These questions are most pertinent to two
populations: patients with amnestic Mild Cognitive Impairment (aMCI), for whom this feedback may be most
motivating, and Black individuals, who may face biopsychosocial barriers to executing adaptive health related
changes, even if motivated to do so. To date, no study has systematically addressed racial differences in
reactions to risk disclosure or the mechanisms underlying these differences. This empirical gap highlights a
timely opportunity to understand and address a potential source of disparity in AD diagnosis and treatment.
The proposed project and closely aligned training plan will respond to this call by comparing behavior change
in individuals who receive either ‘standard of care’ diagnostic disclosure, or diagnostic feedback enhanced by
disclosure of combined PET amyloid and tau imaging. We will build from the robust framework of the Michigan
Alzheimer’s Disease Research Center’s (MADRC) longitudinal cohort and two associated NIA-funded studies
to recruit a biomarker-characterized and rigorously diagnosed sample of 50% Black and 50% White patients
with aMCI. This sample will be randomly assigned to treatment condition, and then followed for bi-annual visits
over two years. Specifically, we will use a mixed-methods approach to assess health behavior change (Aim
1a), advanced planning (Aim 1b), and research participation (Aim 1c), as well as how a known social
determinant of health (healthcare access) influences change in these outcomes by racial group (Aim 2). The
training in AD biomarker measurement and validation, ethical and public health implications of biomarker
disclosure, racial-ethnic disparities in aging, and mixed methods approaches, in addition to the critical concepts
explored in this study, will create the ideal foundation for the principal investigator ...

## Key facts

- **NIH application ID:** 10475212
- **Project number:** 5K23AG070044-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Annalise Rahman-Filipiak
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $184,415
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10475212

## Citation

> US National Institutes of Health, RePORTER application 10475212, Behavioral Change Following Culturally-Informed Biomarker Disclosure in Alzheimer’s Disease (5K23AG070044-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10475212. Licensed CC0.

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