Abstract Body

Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) is a U.S.-wide study evaluating the association between amyloid PET and health outcomes in patients with MCI and dementia. Participants were evaluated by dementia specialists. Amyloid scans were interpreted as “positive” or “negative.” Patient diagnosis and management plans were recorded prior to PET and again 90±30 days following PET. Medicare claims were followed for 12 months and compared to claims from a matched control group of Medicare beneficiaries with MCI/dementia who did not receive amyloid PET. 18,295 patients completed PET between February 2016 and January 2018 (median age 75, 51% female, 87% White, 60% MCI/40% dementia, 61% amyloid positive). A composite management endpoint (changes in AD drugs, other related drugs, counseling about safety and future planning) changed after PET in 60.2% of MCI and 63.5% of dementia patients, exceeding the pre-specified goal of ≥30% (p<0.001). Clinical diagnosis changed from AD to a non-AD condition (or vice versa) in 35.6%. 12 months hospitalization rates were 23.98% in IDEAS compared to 25.12% in controls (relative difference -4.52% [-8.55% - -0.30%]), short of the goal of ≥10% relative reduction. Amyloid-positive patients had a lower risk of 12-months hospitalizations than amyloid-negative patients (Odds Ratio 0.78 [0.71 – 0.87]). In summary, amyloid PET was associated with frequent changes in patient management and a modest reduction in 12-months hospitalizations. Launched in December 2020, New IDEAS will build on these findings in a more diverse cohort of Medicare beneficiaries, with a focus on African-Americans and Latinos and establishment of a biorepository.