Full Breakdown
Willingness of Czech Adults to Undergo Blood-Based Alzheimer’s Biomarker Testing
8/18/2026, 10:43:42 AM
Background & Context
Alzheimer’s disease (AD) poses a growing public-health challenge, prompting interest in early detection through blood-based biomarker (BBBM) assays. While imaging and cerebrospinal-fluid methods exist, BBBM testing offers a less invasive, potentially scalable option for population-level screening. The Czech Republic’s healthcare system currently lacks routine AD screening, and PET imaging was not considered in this study to avoid confounding collection-method preferences.
Study Overview
A quantitative cross-sectional survey gauged Czech adults’ willingness to undergo BBBM testing via a blood draw. Residents aged 35 years or older without neurodegenerative disease were targeted. Data were collected from October 2024 to July 2025 using an online Qualtrics questionnaire. The Ethics Committee of the Faculty of Arts, Charles University approved the project (n. UKFF/2825/2025).
Methodology
Snowball sampling recruited participants through social-media links, email distribution, and requests to companies, organizations, and schools to forward the survey. Of 1,071 initial responses, 666 completed questionnaires met inclusion criteria after excluding 312 incomplete entries, 91 respondents under 35, and 2 individuals with a neurodegenerative disease.
The questionnaire comprised five modules: willingness to undergo testing; sociodemographic data; personal experience with AD; depressive symptoms and AD-related concerns; and medical distrust. After a brief definition of biomarkers, participants answered a four-point Likert item on blood-based testing (definitely yes, probably yes, probably not, definitely not); responses were dichotomized into “yes” (first two options) and “no” (last two). Open-ended items explored motivations for and against testing; parallel questions on lumbar puncture, skin sampling, and saliva collection were excluded from quantitative analysis.
Standardized scales included the Alzheimer’s Disease Knowledge Scale (odd-numbered 15 items), the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, and the Medical Distrust Index (MDI). Internal consistency was acceptable for PHQ-9 (? = 0.78; ? = 0.83) and MDI (? = 0.72; ? = 0.81).
Descriptive statistics compared willing versus unwilling respondents using Mann-Whitney and chi-squared tests with Bonferroni correction. Multivariate logistic regression modeled the probability of BBBM acceptance, reporting odds ratios. Weighted models incorporated gender, region, and combined gender-region adjustments based on Czech Statistical Office data; the fully weighted gender-region model served as the primary analysis. Model fit was evaluated with McFadden R², and collinearity was monitored via variance inflation factors. Qualitative content analysis of open-ended responses involved independent coding by the lead researcher and two assistants (Fleiss’ ? = 0.80).
Key Findings
After adjustment, concern about developing AD was the sole variable retaining significance after Bonferroni correction; higher personal worry increased willingness to undergo BBBM testing. Age, gender, education, AD knowledge, depressive symptoms, and medical distrust were not significant in the primary weighted model. Qualitative themes included perceived benefit of early detection, fear of invasive procedures, and trust in medical institutions.
Implications
Personal concern about AD, rather than demographic or psychosocial variables, drives interest in blood-based screening among Czech adults. Public-health messaging that emphasizes early detection while addressing anxieties may be most effective. Comparable willingness across alternative sample-collection methods underscores the importance of invasiveness in shaping preferences.
Limitations & Gaps
Snowball sampling may limit generalizability despite weighting adjustments. Self-reported data introduce potential response bias, and exclusion of participants with existing neurodegenerative conditions restricts applicability to diagnosed individuals. Future research should employ probability sampling and longitudinal designs to track how willingness evolves as BBBM technologies become routine.
