Duke University, Department of Population Health Sciences, Durham, NC, USA.
Duke-Margolis Centerfor Health Policy, Durham, NC, USA.
J Alzheimers Dis. 2022;90(2):775-782. doi: 10.3233/JAD-220611.
Diagnostic tests, such as amyloid-β positron emission tomography (PET) scans, can increase appropriate therapeutic management for the underlying causes of cognitive decline. To evaluate the full utility of this diagnostic tool, information is needed on whether results from amyloid-β PET scans influence care-partner outcomes.
This study examines the extent to which previous disclosure of elevated amyloid (suggestive of Alzheimer's disease (AD) etiology) versus not-elevated amyloid (not suggestive of AD etiology) is associated with changes in care-partner wellbeing.
The study used data derived from a national longitudinal survey of Medicare beneficiaries (n = 921) with mild cognitive impairment (MCI) or dementia and their care-partners. Care-partner wellbeing outcomes included depressive symptoms (PHQ-8), subjective burden (4-item Zarit burden score), and a 3-item measure of loneliness. Change was measured between 4 (Time 1) and 18 (Time 2) months after receiving the scan results. Adjusted linear regression models regressed change (Time 2-Time 1) in each outcome on scan result.
Care-partners were primarily white, non-Hispanic, college-educated, and married to the care recipient. Elevated amyloid was not associated with statistically significant Time 1 differences in outcomes or with statistically significant changes in depressive symptoms 0.22 (-0.18, 0.61), subjective burden 0.36 (-0.01, 0.73), or loneliness 0.15 (-0.01, 0.32) for care-partners from one time point to another.
Given advances in AD biomarker testing, future research in more diverse samples is needed to understand the influence of scan results on care-partner wellbeing across populations.
诊断测试，如淀粉样蛋白-β正电子发射断层扫描（PET），可以增加对认知能力下降根本原因的适当治疗管理。为了评估这种诊断工具的全部效用，需要了解淀粉样蛋白-β PET 扫描的结果是否会影响护理人员的结果。
本研究考察了先前披露的淀粉样蛋白升高（提示阿尔茨海默病（AD）病因）与未升高（不提示 AD 病因）与护理人员福祉变化之间的关系程度。
该研究使用了来自全国纵向医疗保险受益人大脑健康研究（n=921）的数据，这些人患有轻度认知障碍（MCI）或痴呆症，以及他们的护理人员。护理人员的福祉结果包括抑郁症状（PHQ-8）、主观负担（4 项 Zarit 负担评分）和孤独感的 3 项测量。在收到扫描结果后 4 （时间 1）和 18 （时间 2）个月之间测量变化。调整后的线性回归模型将每个结果的变化（时间 2-时间 1）与扫描结果相关联。
护理人员主要是白人、非西班牙裔、受过大学教育、与护理接受者结婚。淀粉样蛋白升高与结果在时间 1 上没有统计学上的显著差异，也与抑郁症状的统计学上的显著变化无关（0.22[-0.18，0.61]）、主观负担（0.36[-0.01，0.73]）或孤独感（0.15[-0.01，0.32]），从一个时间点到另一个时间点。
鉴于 AD 生物标志物检测的进展，需要在更多样化的样本中进行未来研究，以了解扫描结果对不同人群护理人员福祉的影响。
