This project aims to evaluate the pilot feasibility, acceptability and tolerability of a remotely-delivered, evidence-based, and culturally-appropriate method to remotely disclose apolipoprotein E (APOE) ɛ4 genotypes to cognitively unimpaired Australian adults at-risk of dementia. APOE ɛ4 carriage is the strongest genetic risk factor for the development of sporadic Alzheimer’s disease (AD) dementia, with APOE ɛ4 heterozygotes and homozygotes at 3 and 12 times greater risk of developing AD dementia over their lifetimes, respectively.

Clinical guidelines have historically discouraged APOE testing and disclosure. However, recent approvals of anti-amyloid therapies for the treatment of mild cognitive impairment or mild dementia due to AD in the US, Europe, Asia and now Australia, where APOE genotype predicts treatment efficacy and safety, are changing this. In Australia, APOE testing is now a prerequisite for determining eligibility for anti-amyloid treatment.

Previous US-based studies show that ɛ4 disclosure is feasible and well-tolerated, but approaches may be constrained by region-specific healthcare and insurance systems, norms and social stigmas. In addition, current approaches often use traditional, in-person genetic counselling methods, and have limited scalability. Digital technologies, such as videoconferencing, could be utilised to expand equity of access to evidence-based APOE education and disclosure in light of increasing demand for APOE testing. Consequently, the extent to which APOE disclosure protocols can be adapted and applied in other countries, such as Australia, needs to be examined.

This project will provide important foundational data to guide the development and implementation of APOE disclosure protocols in research and clinical settings in Australia, supporting clinical decision making and the successful delivery of anti-amyloid therapies.

Publications
Rosenich, E., Olver, H., Cummins, H., Karlawish, J. and Lim, Y.Y., 2026. Interest in apolipoprotein E (APOE) disclosure among at-risk, cognitively unimpaired, community-dwelling Australian adults. Journal of Alzheimer’s Disease, 109(1), pp.421-432.

Rosenich, E., Chauhan, S., Haeusler, R., Keriakes, M., Cummins, H., Olver, H., Bransby, L., Maruff, P. and Lim, Y.Y., 2026. Pilot feasibility, acceptability, and tolerability of researcher-delivered apolipoprotein E (APOE) disclosure via videoconferencing in Australian adults at-risk of dementia. Journal of Alzheimer’s Disease, p.13872877261459068.

Competitive Fellowships and Grants
Monash University Faculty of Information Technology Early Career Award Seed Grant (2025-2026) ($30,000 AUD, CIC)
Project Title: Human-Centred AI for Monitoring Therapeutic Fidelity in Coaching for Health-Promoting Behaviour.
Investigators: Varghese (CIA), Ling (CIB), Rosenich (CIC), Lim (CID)