Ethical Disclosure of Biomarkers for Alzheimer Risk in Latin American Participants

Diana Carolina Oviedo^1,2,3Rasheda Haughbrook^4,5Carli Culjat⁶Ladanya Ramirez Surmeier⁷Adam Edmond Tratner^3,8Maria Beatriz Carreira^2,3,8Alcibiades Elias Villarreal^2,3Sherelle L Harmon^5,9Oriana Irina Batista Ceballos^10,11Zhuo Meng⁶EUGENIA MILLENDER^2,6Casey Xavier Hall^12,6*Gabrielle Britton^2,3,6,8*

• ¹Catholic University Santa Maria La Antigua, Panama, Panama
• ²Instituto de Investigaciones Cientificas y Servicios de Alta Tecnologia, Panama City, Panama
• ³Sistema Nacional de Investigación (SNI), SENACYT, Panama City, Panama
• ⁴Center of Population Sciences for Health Empowerment, College of Nursing, Florida State University, Tallahassee, Florida, United States
• ⁵Florida State University Department of Psychology, Tallahassee, United States
• ⁶Center of Population Sciences for Health Empowerment, College of Nursing, Florida State University, Tallahassee, United States
• ⁷College of Social Sciences and Public Policy, Florida State University, Tallahassee, Florida, United States
• ⁸Florida State University, Panama City, Panama
• ⁹Center for Translational Behavioral Science, Florida State University, Tallahassee, United States
• ¹⁰Department of Molecular Genetics and Genomics, Centro Gendiagnostik, S.A, Panama City, Panama
• ¹¹Universidad Autonoma de Chiriqui, David, Panama
• ¹²College of Social Work, Florida State University, Tallahassee, United States

Abstract Introduction: In recent years, the disclosure of Alzheimer's disease (AD) biomarkers has become increasingly common, offering critical insights into disease risk and progression. However, in low-resource settings, where healthcare access, provider training, and patient support are often limited, disclosing AD biomarkers presents unique ethical, logistical, and psychological challenges. Objective: This perspective explores the implications of AD biomarker disclosure in these settings, highlighting the potential risks of patient distress, misinformation, and inadequate follow-up care. For this purpose, we conducted a review of available literature, peer-reviewed studies, regional reports, and policy documents addressing AD in Latin America. Our literature search prioritized diagnostic advances, biomarker disclosure, treatment access, and health system challenges, providing a focused evidence base to frame the discussion of regional gaps and opportunities. Discussion: We discuss strategies to support responsible disclosure practices, including culturally sensitive participant education, enhanced provider training, and policy adaptations to improve accessibility and support systems. Ultimately, we advocate for a careful, context-specific approach to AD biomarker disclosure that prioritizes patient well-being and equity in low-resource environments.