Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI.
VA Advanced Imaging Research Center, San Francisco Veterans Administration Medical Center, San Francisco, CA.
Alzheimer Dis Assoc Disord. 2023;37(3):246-258. doi: 10.1097/WAD.0000000000000569. Epub 2023 Jul 24.
Positron emission tomography (PET) scans for amyloid-β can aid in the early and accurate detection of Alzheimer disease. The results of amyloid PET scans could help people with cognitive impairment and caregivers better understand their diagnosis; however, there are concerns that they could also cause psychological harm.
A systematic review of psychosocial and behavioral quantitative outcomes following the disclosure of an amyloid PET scan for persons living with cognitive impairment (subjective cognitive decline, mild cognitive impairment, Alzheimer's Disease, and other dementias) and caregivers.
Ten papers were identified from 7 studies. There was little evidence of an association between disclosure and depression. However, persons with mild cognitive impairment and their caregivers with elevated levels of amyloid had an increased risk of distress or anxiety compared with those without elevated amyloid. Participants correctly recalled the scan results; however, it is unclear whether this led to an increased understanding of their diagnosis. We did not identify any studies measuring behavioral outcomes.
We found mixed evidence on the relationship between amyloid scans and psychosocial and behavioral outcomes in people with cognitive impairment and caregivers. These findings highlight the need for more methodologically rigorous research on this topic.
正电子发射断层扫描(PET)可用于检测淀粉样蛋白-β,有助于早期、准确地发现阿尔茨海默病。淀粉样蛋白 PET 扫描的结果可以帮助认知障碍患者及其护理人员更好地了解其诊断;然而,人们担心它也可能会造成心理伤害。
对有认知障碍(主观认知下降、轻度认知障碍、阿尔茨海默病和其他痴呆症)的患者及其护理人员进行淀粉样蛋白 PET 扫描后,对其进行心理社会和行为学定量结果的系统评价。
从 7 项研究中确定了 10 篇论文。有证据表明披露结果与抑郁之间没有关联。然而,与没有淀粉样蛋白升高的人相比,轻度认知障碍患者及其有淀粉样蛋白升高的护理人员有更高的焦虑或抑郁风险。参与者正确地回忆了扫描结果;然而,目前尚不清楚这是否增加了他们对诊断的理解。我们没有发现任何衡量行为结果的研究。
我们发现,淀粉样蛋白扫描与认知障碍患者及其护理人员的心理社会和行为结果之间的关系存在混合证据。这些发现强调了需要在这一主题上开展更多具有严格方法学的研究。