Effect of amyloid pet results disclosure on health-related behaviors in persons with mild cognitive impairment

Abstract Mounting evidence supports the clinical utility of amyloid PET. However, whether patients use knowledge of their amyloid status to alter health behaviors remains unclear. We describe health-related actions taken by Mild Cognitive Impairment patients following amyloid PET disclosure (n=34) vs. a comparison group (n=37). Patients were 92% non-Hispanic white, 59% male, 73±8.61 years old with 16.25±2.49 years of education. Over 12 months of follow-up, all participants reported at least one behavior change from baseline on a 14-item health behavior questionnaire. Amyloid positive patients reported the most behavior changes (mean=4.67±1.83) while amyloid negative patients reported the fewest (mean=3.72±1.58). Across groups, no significant differences were observed in: lifestyle, vitamin/supplement use, stress reduction activities, cognitive stimulation, or advance directive completion. Amyloid negative participants were significantly less likely than controls to consider long-term care insurance (63.6% vs. 89.2%; P=.025), and to endorse changes classified as “other” (36.4% vs. 64.9%; P=0.037). After adjusting for education level, gender, and MMSE, logistic regression showed that amyloid negative patients were 74% less likely than controls to report “other” changes (OR=0.26, 95% CI [0.08, 0.85], P=0.025), and 78% less likely to consider long-term care insurance (OR=0.22, 95% CI [0.06, 0.86], P=0.03). Qualitative analysis of supplemental interviews with scan group participants revealed “other” activities to include changes in employment, driving, and residential status, and engagement in other non-medical activities (pursuing bucket lists and mending strained relationships). Health-related behavior changes following amyloid PET disclosure may differ by scan result and encompass actions to enhance not only cognition but quality of life.