Analysis of psychological symptoms following disclosure of amyloid-positron emission tomography imaging results to adults with subjective cognitive decline

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• dc.contributor.author Caprioglio, Camilla
• dc.contributor.author Minguillón, Carolina
• dc.contributor.author Grau-Rivera, Oriol
• dc.contributor.author Molinuevo, José Luis
• dc.contributor.author Gispert López, Juan Domingo
• dc.contributor.author AMYPAD Consortium
• dc.date.accessioned 2024-02-12T08:03:16Z
• dc.date.available 2024-02-12T08:03:16Z
• dc.date.issued 2023
• dc.description.abstract Importance Individuals who are amyloid-positive with subjective cognitive decline and clinical features increasing the likelihood of preclinical Alzheimer disease (SCD+) are at higher risk of developing dementia. Some individuals with SCD+ undergo amyloid-positron emission tomography (PET) as part of research studies and frequently wish to know their amyloid status; however, the disclosure of a positive amyloid-PET result might have psychological risks. Objective To assess the psychological outcomes of the amyloid-PET result disclosure in individuals with SCD+ and explore which variables are associated with a safer disclosure in individuals who are amyloid positive. Design, Setting, and Participants This prospective, multicenter study was conducted as part of The Amyloid Imaging to Prevent Alzheimer Disease Diagnostic and Patient Management Study (AMYPAD-DPMS) (recruitment period: from April 2018 to October 2020). The setting was 5 European memory clinics, and participants included patients with SCD+ who underwent amyloid-PET. Statistical analysis was performed from July to October 2022. Exposures Disclosure of amyloid-PET result. Main Outcomes and Measures Psychological outcomes were defined as (1) disclosure related distress, assessed using the Impact of Event Scale–Revised (IES-R; scores of at least 33 indicate probable presence of posttraumatic stress disorder [PTSD]); and (2) anxiety and depression, assessed using the Hospital Anxiety and Depression scale (HADS; scores of at least 15 indicate probable presence of severe mood disorder symptoms). Results After disclosure, 27 patients with amyloid-positive SCD+ (median [IQR] age, 70 [66-74] years; gender: 14 men [52%]; median [IQR] education: 15 [13 to 17] years, median [IQR] Mini-Mental State Examination [MMSE] score, 29 [28 to 30]) had higher median (IQR) IES-R total score (10 [2 to 14] vs 0 [0 to 2]; P < .001), IES-R avoidance (0.00 [0.00 to 0.69] vs 0.00 [0.00 to 0.00]; P < .001), IES-R intrusions (0.50 [0.13 to 0.75] vs 0.00 [0.00 to 0.25]; P < .001), and IES-R hyperarousal (0.33 [0.00 to 0.67] vs 0.00 [0.00 to 0.00]; P < .001) scores than the 78 patients who were amyloid-negative (median [IQR], age, 67 [64 to 74] years, 45 men [58%], median [IQR] education: 15 [12 to 17] years, median [IQR] MMSE score: 29 [28 to 30]). There were no observed differences between amyloid-positive and amyloid-negative patients in the median (IQR) HADS Anxiety (–1.0 [–3.0 to 1.8] vs –2.0 [–4.8 to 1.0]; P = .06) and Depression (–1.0 [–2.0 to 0.0] vs –1.0 [–3.0 to 0.0]; P = .46) deltas (score after disclosure – scores at baseline). In patients with amyloid-positive SCD+, despite the small sample size, higher education was associated with lower disclosure-related distress (ρ = –0.43; P = .02) whereas the presence of study partner was associated with higher disclosure-related distress (W = 7.5; P = .03). No participants with amyloid-positive SCD+ showed probable presence of PTSD or severe anxiety or depression symptoms at follow-up. Conclusions and Relevance The disclosure of a positive amyloid-PET result to patients with SCD+ was associated with a bigger psychological change, yet such change did not reach the threshold for clinical concern.
• dc.description.sponsorship The Geneva Memory Center is funded by the following private donors under the supervision of the Private Foundation of Geneva University Hospitals: Association Suisse pour la Recherche sur la Maladie d’Alzheimer, Genève; Fondation Segré, Genève; Ivan Pictet, Genève; Fondazione Agusta, Lugano; Fondation Chmielewski, Genève. Competitive research projects have been funded by H2020, Human Brain Project, Innovative Medicines Initiative 2, Swiss National Science Foundation, VELUX Foundation. The BBRC’s memory center received funding from the Barcelona City Council (agreement #20XC0354) and Biogen. Dr Caprioglio was supported by EU-EFPIA Innovative Medicines Initiative 2 Joint Undertaking (IMI 2 JU) Amyloid Imaging to Prevent Alzheimer’s Disease (AMYPAD, grant agreement number: 115952). Dr Grau-Rivera received funding from Alzheimer’s Association (2019-AARF-644568) and Instituto de Salud Carlos III (PI19/00117). Dr Domingo Gispert is supported by the Spanish Ministry of Science and Innovation (RYC-2013-13054) and received funding by the EU-EFPIA Innovative Medicines Initiative 2 Joint Undertaking (IMI 2 JU) Amyloid Imaging to Prevent Alzheimer’s Disease (AMYPAD, grant agreement number: 115952).
• dc.format.mimetype application/pdf
• dc.identifier.citation Caprioglio C, Ribaldi F, Visser LNC, Minguillon C, Collij LE, AMYPAD consortium, et al. Analysis of psychological symptoms following disclosure of amyloid-positron emission tomography imaging results to adults with subjective cognitive decline. JAMA Netw Open. 2023 Jan 3;6(1):e2250921. DOI: 10.1001/jamanetworkopen.2022.50921
• dc.identifier.doi http://dx.doi.org/10.1001/jamanetworkopen.2022.50921
• dc.identifier.issn 2574-3805
• dc.identifier.uri http://hdl.handle.net/10230/59076
• dc.language.iso eng
• dc.publisher American Medical Association
• dc.relation.ispartof JAMA Netw Open. 2023 Jan 3;6(1):e2250921
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/115952
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/RYC-2013-13054
• dc.rights © 2023 Caprioglio C et al. JAMA Network Open. This is an open access article distributed under the terms of the CC-BY License (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.other Tomografia per emissió de positrons
• dc.subject.other Alzheimer, Malaltia d’-Diagnòstic
• dc.subject.other Alzheimer, Malaltia d’-Pacients
• dc.subject.other Alzheimer, Malaltia d’-Tomografia
• dc.subject.other Trastorns de la cognició en la vellesa
• dc.subject.other Trastorns de la memòria en la vellesa
• dc.subject.other Deteriorament cognitiu lleu
• dc.subject.other Cervell-Imatgeria
• dc.subject.other Cervell-Malalties-Diagnòstic
• dc.subject.other Cervell-Tomografia
• dc.title Analysis of psychological symptoms following disclosure of amyloid-positron emission tomography imaging results to adults with subjective cognitive decline
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion