Nurse-led pre-test counseling for Alzheimer's disease biomarker testing: Knowledge and skills required to meet the needs of patients and families

• Published in: Geriatric nursing (New York) Vol. 53; pp. 130 - 134
• Main Authors: Greer, Olivia, Cheng, Rebekah, Tamres, Lisa K., Mattos, Meghan, Morris, Jonna L., Knox, Melissa L., Lingler, Jennifer H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2023
• Subjects: Alzheimer Disease - diagnosis; Alzheimer's disease; Amyloid PET; Biomarkers; Cognitive Dysfunction - psychology; Counseling; Humans; Mild cognitive impairment; Nurse's Role; Nurse-patient communication; Patient education; Positron-Emission Tomography - methods; Patient education; Nurse-patient communication; Mild cognitive impairment; Amyloid PET; Alzheimer's disease
• ISSN: 0197-4572; 1528-3984
• DOI: 10.1016/j.gerinurse.2023.07.007

•Biomarker tests for Alzheimer's disease (AD) pathology are proliferating.•Pre-test counseling (PTC) for AD biomarker testing is an emerging role for nurses.•Key functions of PTC include disease-specific education and emotional support.•Nurse-led PTC yields rich exchanges with patients and family members and promotes informed decision-making. Biomarker testing for Alzheimer's disease and related disorders (ADRD) brings new opportunities for nurses to foster shared decision-making by leading pre-test counseling (PTC) for patients and families. Audio-recordings of 18 nurse-led PTC sessions were analyzed to characterize questions posed by patient and family members dyads considering whether to pursue amyloid positron emission tomography. Sessions lasted 20 to 75 minutes and generated rich discussion of the purpose and potential implications of amyloid imaging. Dyads posed questions regarding: basic neuroanatomy; the spectrum of normal cognitive aging to dementia; clinical phenotypes and pathological hallmarks of ADRD; secondary prevention of ADRD; and advance planning. In response, PTC facilitators provided disease-specific education, clarification of overt misconceptions, caregiver support, and emotion de-escalation. Nurses conducting PTC for AD biomarker testing should be equipped to answer questions about topics both directly and indirectly related to testing, and also provide emotional support.