{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T22:31:52Z","timestamp":1777761112149,"version":"3.51.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIA P30 AG 072979"],"award-info":[{"award-number":["NIA P30 AG 072979"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K23AG065442"],"award-info":[{"award-number":["1K23AG065442"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K23AG065442-03S1"],"award-info":[{"award-number":["1K23AG065442-03S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01AG064123"],"award-info":[{"award-number":["K01AG064123"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["AARF-17-528934"],"award-info":[{"award-number":["AARF-17-528934"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U48 DP\u2014005053"],"award-info":[{"award-number":["U48 DP\u2014005053"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Early diagnosis of Alzheimer\u2019s disease (AD) using brain scans and other biomarker tests will be essential to increasing the benefits of emerging disease-modifying therapies, but AD biomarkers may have unintended negative consequences on stigma. We examined how a brain scan result affects AD diagnosis confidence and AD stigma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study used a vignette-based experiment with a 2\u2005\u00d7\u20052\u2005\u00d7\u20053 factorial design of main effects: a brain scan result as positive or negative, treatment availability and symptom stage. We sampled 1,283 adults ages 65 and older between June 11and July 3, 2019. Participants (1) rated their confidence in an AD diagnosis in each of four medical evaluations that varied in number and type of diagnostic tools and (2) read a vignette about a fictional patient with varied characteristics before completing the Modified Family Stigma in Alzheimer\u2019s Disease Scale (FS-ADS). We examined mean diagnosis confidence by medical evaluation type. We conducted between-group comparisons of diagnosis confidence and FS-ADS scores in the positive versus negative brain scan result conditions and, in the positive condition, by symptom stage and treatment availability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A positive versus negative test result corresponds with higher confidence in an AD diagnosis independent of medical evaluation type (all p\u2005&amp;lt;\u2005.001). A positive result correlates with stronger reactions on 6 of 7 FS-ADS domains (all p\u2005&amp;lt;\u2005.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>A positive biomarker result heightens AD diagnosis confidence but also correlates with more AD stigma. Our findings inform strategies to promote early diagnosis and clinical discussions with individuals undergoing AD biomarker testing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geronb\/gbae109","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:46:22Z","timestamp":1718361982000},"source":"Crossref","is-referenced-by-count":6,"title":["Double-Edged Sword: A Positive Brain Scan Result Heightens Confidence in an Alzheimer\u2019s Diagnosis But Also Leads to Higher Stigma Among Older Adults in a Vignette-Based Experiment"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3994-4343","authenticated-orcid":false,"given":"Shana D","family":"Stites","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6090-4306","authenticated-orcid":false,"given":"Brian N","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-5077","authenticated-orcid":false,"given":"Emily A","family":"Largent","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5360-1043","authenticated-orcid":false,"given":"Kristin","family":"Harkins","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Sankar","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abba","family":"Krieger","sequence":"additional","affiliation":[{"name":"Department of Statistics, Wharton School of Business, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7483-4137","authenticated-orcid":false,"given":"Rebecca T","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"issue":"4","key":"2024071110152052400_CIT0001","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1002\/alz.13016","article-title":"2023 Alzheimer\u2019s disease facts and figures","volume":"19","author":"Alzheimer\u2019s Association","year":"2023","journal-title":"Alzheimer\u2019s & Dementia"},{"issue":"2","key":"2024071110152052400_CIT0002","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1017\/S0714980821000192","article-title":"Stigma reduction interventions of dementia: A scoping review","volume":"41","author":"Bacsu","year":"2022","journal-title":"Canadian Journal on Aging\/La Revue Canadienne Du Vieillissement"},{"key":"2024071110152052400_CIT0003","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.copsyc.2016.05.006","article-title":"Awareness of the prime versus awareness of its influence: Implications for the real-world scope of unconscious higher mental processes","volume":"12","author":"Bargh","year":"2016","journal-title":"Current Opinion in Psychology"},{"issue":"1","key":"2024071110152052400_CIT0004","doi-asserted-by":"crossref","first-page":"1.e2","DOI":"10.1016\/j.annemergmed.2010.10.018","article-title":"Patient perceptions of computed tomographic imaging and their understanding of radiation risk and exposure","volume":"58","author":"Baumann","year":"2011","journal-title":"Annals of Emergency Medicine"},{"issue":"3","key":"2024071110152052400_CIT0005","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.newideapsych.2012.01.002","article-title":"Is social projection based on simulation or theory? 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