Perceptions of Amyloid Imaging Among Cognitively Normal Older Adults with Elevated and Not Elevated Amyloid

Abstract

Preclinical Alzheimer’s disease (AD) clinical trials screen cognitively unimpaired older adults for biomarker criteria and disclose their individual results. We examined if participants in the Anti-Amyloid treatment in Asymptomatic Alzheimer’s disease (A4) Study with “elevated” and “not elevated” amyloid differed in scores on the “Views and Perceptions of Amyloid Imaging” scale. We hypothesized that, prior to disclosure, those with elevated amyloid would score higher than those with not elevated amyloid and that this would be mediated by participant Cognitive Function Instrument (CFI) score. We also quantified how questionnaire responses changed after result disclosure. We assessed data from 4,327 individuals who completed the Views and Perceptions of Amyloid Imaging questionnaire at screening visit 1 and after amyloid disclosure. We used linear regression models to assess the relationship between four category scores and amyloid status. Participant age, education, sex, ethnoracial group, and study partner spousal status were adjusted as potential confounders. We also quantified the relationship between category score changes and amyloid status, additionally controlling for pre-disclosure score. Overall, participants scored altruism and contribution to research the strongest motivations for amyloid imaging. Those with elevated amyloid scored 0.23 points higher in the Perceived Risk category, on average, than those who had not elevated amyloid prior to disclosure; this effect attenuated towards zero after adjusting for CFI. After disclosure, participants with elevated amyloid demonstrated less within-subject change in Perceived Risk score, on average, compared to those with similar pre-disclosure scores who had not elevated amyloid, while demonstrating greater changes in the altruism and planning categories. Altruism and learning disease risk represented the reasons most important to participants for learning amyloid imaging results. Preclinical AD trial participants with elevated amyloid differed from their not elevated counterparts in their perceptions of amyloid imaging, even before undergoing the procedure.

Mary M. Ryan

Assistant Professor
mary [dot] ryan [at] wisc [dot] edu

My research interests include group sequential design and clinical trials, with applications in Alzheimer’s Disease biomarker discovery, as well as pragmatic and cluster randomized trials.