Alzheimer's Imaging Consortium.

Area of Science:

• Neuroimaging and Dementia Research
• Pharmacological Management of Cognitive Impairment
• Health Disparities in Geriatric Care

Background:

• Socioeconomic factors and healthcare settings create disparities in dementia assessment.
• The impact of these disparities on dementia management remains unclear.
• The study investigates amyloid PET's influence on pharmacological management across diverse patient and practice settings.

Purpose of the Study:

• To compare the impact of amyloid PET on pharmacological management across social factors, patient comorbidities, and physician practice settings.
• To analyze changes in Alzheimer's disease (AD) and non-AD drug prescriptions post-amyloid PET scans.
• To identify associations between social determinants, comorbidities, clinical setting, and management changes.

Main Methods:

• Analysis of data from the Imaging Dementia - Evidence for Amyloid Scanning (IDEAS) study.
• Inclusion of participants with visually interpretable amyloid PET scans and pre/post-PET assessments.
• Statistical modeling using multilevel logistic regression to assess management changes related to social factors, comorbidities, and practice settings.

Main Results:

• Pharmacological management changes were associated with dyslipidemia, depression, and tobacco use.
• Non-AD drug management changes linked to depression, group practice, and area deprivation index (ADI) in amyloid-positive individuals.
• Rates of change were also associated with amyloid-PET status, impairment level, and dementia etiology.

Conclusions:

• Amyloid status, cognitive impairment, dementia etiology, and comorbidities inform pharmacological decisions.
• Amyloid PET can help optimize treatment, particularly for co-occurring conditions like depression.
• Socioeconomic disadvantage may affect clinical response to amyloid-positivity, warranting further investigation into access barriers.