IDEAS and New IDEAS: Amyloid PET in diverse populations

Abstract

Background: Imaging biomarkers for neurodegenerative disease are understudied in diverse populations. The completed Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) and recently launched New IDEAS studies evaluate the clinical impact of amyloid PET in large samples of Medicare beneficiaries across the U.S. with MCI or dementia, enabling comparisons between patients from different racial and ethnic backgrounds. Method: Amyloid PET was performed in 18,295 IDEAS Study participants recruited from 590 clinical sites between 2016-2018. Dementia specialists completed pre-and post-PET case report forms. Medicare claims were followed for 12 months. New IDEAS will enroll 7000 Medicare beneficiaries (minimum 2000 African Americans and 2000 Latinos) with MCI or dementia at ∼350 memory clinics across the US between 2020-2023, following analogous procedures. Quantified social determinants of health (quality of education, midlife/current income, marital status and living arrangement) will be measured. A team involving Vanderbilt University, University of North Carolina and the Alzheimer's Association will use community engaged research principles (community stakeholders as study champions, tailored recruitment strategies) to ensure cohort diversity.Result: Recruitment in IDEAS included a low proportion of minority participants (83.9% White (N=15,568), 3.4% African American (N=639), 4.6% Hispanic (N=848), 1.8% Asian (N=328)). The proportion of positive amyloid scans was lower for African Americans (53.8%), Hispanics (54%) and Asians (45.1%) compared to Whites (62.7%).African Americans (52%), Hispanics (56%) and Asians (47%) presented more frequently with dementia (as opposed to MCI) than Whites (37%). There were disparities in vascular risk factors (hypertension/diabetes: 68%/28% African Americans, 55%/26% Hispanics, 48%/25% Asians, 50%/15% Whites) and lower educational attainment for African Americans and Hispanics. New IDEAS will examine the impact of amyloid PET on health outcomes and patient management in the total cohort and

Quantification of amyloid PET for future clinical use: a state-of-the-art review

“…In addition, differences among racial and ethnic groups are under investigation in the Health & Aging Brain among Latino Elders (HABLE) [ 209 ]. The next IDEAS phase aims to address racial disparities by recruiting a diverse cohort of at least 2,000 African American and 2,000 Latino subjects among the planned study population of 7,000 [ 210 ]. The IDEAS team recently published their PET-only processing pipeline to support the use of standardised quantitative measures in heterogeneous datasets [ 211 ].…”

Accelerating diversity in Alzheimer's disease research by partnering with a community advisory board

“…CER is a process to incorporate the voices of the communities as equal partners in the development and outcomes of research. Community Advisory Boards (CABs) serve as the voice of the community and can provide invaluable insight about the development of culturally sensitive outreach and recruitment strategies 4,5 . Partnerships with CABs present a promising opportunity to accelerate enrollment of underrepresented groups (URGs), particularly for racial and ethnic minority groups 6–8 .…”

“…Community Advisory Boards (CABs) serve as the voice of the community and can provide invaluable insight about the development of culturally sensitive outreach and recruitment strategies. 4 , 5 Partnerships with CABs present a promising opportunity to accelerate enrollment of underrepresented groups (URGs), particularly for racial and ethnic minority groups. 6 , 7 , 8 The most populous URGs in Indiana are those who self‐identify as African American or Black and will be the focus of this URG framework.…”