Ethical Guidelines of the Alzheimer Society of Canada

Fisk, John D.; Sadovnick, A. Dessa; Cohen, Carole; Gauthier, Serge; Dossetor, John B.; Eberhart, Astrid; Leduc, Linda

doi:10.1017/s0317167100034089

Cited by 20 publications

(16 citation statements)

References 46 publications

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“…Improving the predictive validity of APOE genotyping, by combining it with neuropsychological testing, begins to approach the necessary conditions for using genetic testing in clinical practice. While advances in genetics have made predictive testing for AD appropriate for some families, genetic risk assessment for AD, such as that associated with APOE genotyping, has not yet been considered ethically appropriate [29,30]. The current findings require replication in other population-based samples.…”

Section: Discussionmentioning

confidence: 99%

APOE Genotype, Memory Test Performance, and the Risk of Alzheimer’s Disease in the Canadian Study of Health and Aging

Klages

Fisk²,

Rockwood³

2002

Dement Geriatr Cogn Disord

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Objective: This study examined the relation between two risks for Alzheimer’s disease (AD): the apolipoprotein (APOE) Ε4 allele and poor memory test performance. Methods: In the Canadian Study of Health and Aging (CSHA), a 5-year longitudinal population-based study that screened and followed over 10,000 participants, 2,914 had an initial clinical assessment and 1,624 had APOE genotype testing. All participants were categorized as having no cognitive impairment, cognitive impairment but no dementia, or dementia at both baseline and follow-up. We examined those (n = 209) with a complete neuropsychological assessment at baseline and no evidence of cognitive impairment who had either APOE Ε3/Ε3 or Ε3/Ε4 genotypes and who had a clinical consensus diagnosis of either no cognitive impairment or AD at follow-up. Delayed free recall memory was evaluated at CSHA-1 with the Buschke Cued Recall Test (BCRT). Results: The risk of AD at follow-up was increased for participants with an APOE Ε3/Ε4 genotype when memory test performance was not considered, but logistic regression demonstrated that a model which also considered baseline memory test performance was more predictive of AD. In the more complete model, reduced BCRT free recall scores were associated with an increased risk of AD, whereas the risk associated with the APOE Ε3/Ε4 genotype was no longer significant. Conclusions: For those with no evidence of cognitive impairment, drawn from a population-based sample of elderly persons, the APOE Ε3/Ε4 genotype was only associated with an increased risk of AD after 5 years if their memory test performance was relatively poor at baseline. Regardless of the APOE genotype, and in the absence of clinical evidence of cognitive impairment, reduced scores on a test of delayed free recall at baseline was associated with an increased risk of AD after 5 years.

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Section: Discussionmentioning

confidence: 99%

APOE Genotype, Memory Test Performance, and the Risk of Alzheimer’s Disease in the Canadian Study of Health and Aging

Klages

Fisk²,

Rockwood³

2002

Dement Geriatr Cogn Disord

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“…This is not to say that ethical discussion is always a response to external developments or that the discourse is completely determined by such developments. Indeed, in some circumstances ethics has taken the lead-perhaps most visibly with the development of ethical guidelines by the Canadian Alzheimer's Society Ethics Task Force in the mid-1990s through the process of discourse ethics involving professionals, family carers and people with dementia (see Post and Whitehouse, 1995;Fisk et al, 1998;Cohen et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Ethics and dementia: mapping the literature by bibliometric analysis

Baldwin

Hughes

Hope

et al. 2002

Int J Geriat Psychiatry

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“…Responsibility, however, remains with the researcher to ensure that involvement is in participants' best interests and concords with their wishes. Fisk et al (1998) suggest researchers have an obligation to ensure any decision is guided by the individual's wishes. Assent from the person with dementia is required even when the proxy has given consent.…”

Section: Consentmentioning

confidence: 99%