Talk to Patients About Elevated Amyloid PET Results

When speaking with cognitively unimpaired older adults, clinicians should be prepared to explain the meaning of brain PET results that show signs of elevated beta-amyloid plaque, according to a study published in JAMA Neurology.

Researchers from the University of Pennsylvania and the Penn Neuroscience Center, both in Philadelphia, and the Washington University School of Medicine in St Louis, Missouri, sought to determine how cognitively unimpaired adults understood the meaning of an elevated amyloid PET biomarker.

Initially, 80 subjects participated in The Study of Knowledge and Reactions to Amyloid Testing, a substudy of an Alzheimer’s disease prevention trial. The study involved two semistructured telephone interviews with the participants. Fifty subjects had received elevated amyloid PET scan results and 30 did not have elevated scan results. The 50 with elevated amyloid PET markers were aged 65 to 85 and cognitively normal; 49 (98%) were white, 40 (80%) reported a family history of AD, and 30 (60%) had a postgraduate educational level.

The subjects were interviewed four to 12 weeks after they received their results and again one year later. The questions asked were:

• What was the result of your amyloid PET scan? (followed by “Can you tell me in your own words what that means?” or “How would you explain it to a friend?”)

• Was it the result you expected?

• Did the result teach you anything or clarify anything for you?

The results showed 31 the 50 participants (62%) with elevated levels understood that elevated amyloid conferred an increased but uncertain risk of developing AD. Some looked for a better understanding of the term elevated other than it being a categorical result enabling trial entry eligibility; they wanted information regarding how elevated their amyloid was, how close to the study threshold they were, or percentages, numbers, or a scale to help them make sense of the result.

The researchers concluded that cognitively unimpaired seniors who are told they have elevated amyloid markers want to know what this means and if there is anything they can do about it. Physicians should be ready to discuss