Numeracy and recall of Alzheimer’s disease risk information: Effects of risk format in a Latino community

Purpose Accurate recall of risk information is essential for informed decision-making, yet the influence of numeracy on risk recall among Latinos is unknown. We examined the relations of numeracy to recall of Alzheimer's disease (AD) risk and APOE genotypes among Latino participants in the IDEAL Study.Methods Latinos aged 40-64 (N = 310) randomized to receive AD risk estimates to age 85 with or without APOE genotype information completed five numeracy items before risk disclosure. Risk estimates were delivered by genetic counselors in two formats: percentage and number out-of-20. Six weeks after disclosure, participants reported recall of risks in both formats, risk relative to other Latinos in their community, APOE-ε4 carrier status, and APOE genotype. Logistic regression was used to assess associations of numeracy with recall accuracy, adjusting for sociodemographic factors.Results Numeracy was increased among men, participants of Mexican descent, and those who had higher education, higher income, or greater identification with non-Latinos. Among all participants, 40% correctly recalled their exact risk percentage and 37% correctly recalled their exact risk estimate out-of-20. Among participants told their APOE genotype, 75% correctly recalled their APOE-ε4 carrier status, but only 24% their specific genotype. Higher numeracy was associated with better recall of risk estimates presented out-of-20, but not with recall of genotype, percentage-based risk estimates, or risk relative to others.Conclusions Numeracy was associated with recall of some, but not all, forms of AD risk information. Percentage-based risk estimates were recalled somewhat better overall, and recall of risk presented out-of-20 was dependent on numeracy.Practice implications Selection of risk formats that minimize cognitive burden may improve retention of risk information, particularly among persons with lower numeracy. Use of simplified numeric formats and supportive communication strategies may enhance the effectiveness of AD risk disclosure in diverse populations.