Date of Award

Winter 12-15-2022

Author's School

Graduate School of Arts and Sciences

Author's Department


Degree Name

Doctor of Philosophy (PhD)

Degree Type



As Alzheimer disease research forges ahead, and new potential treatments are developed, a conceptualization is emerging of a presymptomatic disease stage. This stage, known as preclinical Alzheimer disease, is characterized by the buildup of amyloid beta and tau proteins in the brain to abnormal levels in a cognitively normal person. There are unknown potential risks and benefits of communicating biological marker risk information for Alzheimer disease using the preclinical Alzheimer disease diagnostic label. The current study uses a vignette methodology to measure older adults’ understanding of risk information when presented with information regarding their risk for developing Alzheimer dementia. Participants (n = 300) were randomized to receive biomarker results and risk information (with or without the preclinical disease label) pertaining either to heart disease or Alzheimer disease. Participants then reported on their individual perceptions, based on the Health Belief Model, and declared their behavioral intentions in response to this information. Results support the idea that the addition of a preclinical Alzheimer disease label does not influence perception of the disease or behavioral intentions. Results also highlight differences in individual perceptions of Alzheimer disease versus heart disease such that participants in the Alzheimer disease conditions perceived their risk information as implying a more severe condition, perceived fewer benefits to knowing their risk, and reported lower self-efficacy about doing anything to address that risk. Despite these perceptions, older adults who received risk information for Alzheimer disease maintained interest in undertaking behavioral changes that may improve their quality-of-life. These findings have implications for the development of empirically supported disclosure processes for preclinical Alzheimer disease.


English (en)

Chair and Committee

Brian D. Carpenter

Committee Members

David Balota, Denise Head, Patrick Hill, Jessica Mozersky,