Alzheimer's Imaging Consortium

Area of Science:

• Neurology
• Nuclear Medicine
• Geriatrics

Background:

• Prior studies on amyloid PET's clinical impact underrepresented diverse ethnoracial groups.
• The New IDEAS study investigated amyloid PET's association with management changes in diverse Medicare beneficiaries with cognitive impairment.
• The study also focused on patients with atypical (non-memory predominant) presentations of Alzheimer's disease (AD).

Purpose of the Study:

• To determine if amyloid PET use is associated with changes in clinical management among ethnoracially diverse Medicare beneficiaries with cognitive impairment.
• To assess the impact of amyloid PET on management strategies for patients with typical and atypical presentations of Alzheimer's disease (AD).
• To evaluate the real-world utility of amyloid PET in guiding clinical decisions for a broad patient population.

Main Methods:

• A national, multi-site, prospective, longitudinal study (New IDEAS) enrolled Medicare beneficiaries with mild cognitive impairment (MCI) or dementia.
• Participants underwent amyloid PET scans as recommended by their dementia specialists.
• The primary endpoint was the change in clinical management within 90 days post-PET, including medication and counseling adjustments.

Main Results:

• The study included 4363 participants, with significant representation from Black/African American (21.5%) and Hispanic/Latino (16.2%) individuals.
• Overall, 65.4% of participants were amyloid PET positive.
• Changes in clinical management occurred in over 53% of participants across different ethnoracial groups and clinical presentations, with significant interactions noted between Black/African American identity and positive amyloid PET scans.

Conclusions:

• Amyloid PET use is associated with changes in clinical management for ethnoracially diverse Medicare beneficiaries with cognitive impairment.
• The findings highlight the value of amyloid PET as a biomarker in real-world clinical settings for both typical and atypical Alzheimer's disease (AD) presentations.
• This study supports the integration of amyloid PET imaging into routine dementia care to guide management decisions.