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Too much information? Asian Americans' preferences for incidental brain MRI findings

Kota, K. J.; Dawson, A.; Papas, J.; Sotelo, V.; Su, G.; Li, M.-L.; Lee, W.; Estervil, J.; Marquez, M.; Sarkar, S.; Lopez, L. L.; Hu, W. T.

2023-04-24 neurology
10.1101/2023.04.17.23288629 medRxiv
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INTRODUCTIONSouth Asian (SA) and East Asian (EA) older adults represent the fastest growing group of Americans at risk for dementia, but their participation in aging and dementia research has been limited. While recruiting healthy SA older adults into a brain health study, we encountered unexpected hesitancy towards structural brain MRI analysis along with some stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as ones own MRI experience, perceived MRI safety, and concerns for ones own risks for future dementia/stroke. METHODSWe developed a brief cross-sectional survey to assess older adults MRI experiences and perceptions, desire to learn of six incidental findings of increasing health implications, and attitudes related to dementia as well as research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey, and modeled the proportional odds (P.O.) for pro-research attitudes. RESULTS77 SA and 84 EA respondents were analyzed with 95 non-Asian adults. White (P.O.=2.54, p=0.013) and EA (P.O.=2.14, p=0.019) respondents were both more likely than SA respondents to endorse healthy volunteers participation in research, and the difference between White and SA respondents was mediated by the latters greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p=0.006), but still shared SA respondents low desire to learn of incidental MRI findings. DISCUSSIONSA and EA older adults had different attitudes towards future dementia/stroke risks, but shared a low desire to learn of incidental MRI findings. A culturally-appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research. Color printingPlease have figure one and two be in color; figure three is in black and white

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