Despite higher Alzheimer’s risk, patients can handle amyloid PET exam results

Clinicians can feel comfortable sharing Alzheimer’s biomarker imaging results with older patients who don’t have cognitive impairment.

That’s because, according to a study published Tuesday in JAMA Neurology, individuals who learned they had elevated amyloid levels did not suffer from more short-term anxiety, depression, or suicidal thoughts compared to those without higher levels.

Disclosing such information is not currently recommended in clinical practice. But these results suggest it is safe to do so, at least in short-term preclinical Alzheimer’s disease trials, reported Joshua D. Grill, PhD, with University of California, Irvine, and colleagues.

“Individuals with elevated amyloid levels understood that their biomarker result conferred increased risk for AD dementia. This perception of increased risk, perhaps notably, did not appear to be associated with adverse psychological reactions, namely anxiety or depression,” Grill et al. added. “Whether such associations develop over time will be a key area of future research.”

For their study, the team analyzed older adults with normal cognition who participated in the A4 multisite randomized clinical trial from April 2014 to December 2017, a phase III trial investigating the anti-amyloid drug solanezumab.

In total, 1,167 patients with elevated amyloid levels were involved, along with 538 without such findings. Participants, who were 72 years old, on average, underwent an amyloid PET scan and received their results from an individual who delivered findings via a protocol-specified process that included prescan education and psychological assessments.

Upon reviewing these assessments, taken 42 to 57 days after receiving amyloid results, scores for anxiety, depression and suicide were similar between both groups. Those with elevated amyloid, however, scored higher regarding concern about Alzheimer’s disease. On the other hand, people without elevated amyloid scored higher on a test measuring self-perceived life expectancy.

“The current results, although not generalizable to diverse clinical settings or the general population, suggest that trial participants internalize biomarker information without experiencing immediate mental health sequelae,” the authors wrote.

Grill et al. suggested that, in the future, biomarker testing can hopefully spot patients with preclinical Alzheimer’s who may benefit from targeted therapy. Safe disclosure methods will be needed if and when that day does come, and the current results may be a good starting point.

More research will be needed, they added, to investigate whether receiving this knowledge motivates patients to enact lifestyle changes to combat dementia or other long-term life planning.

Read the entire study here.