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. 2024 Sep;20(9):6060-6069.
doi: 10.1002/alz.14077. Epub 2024 Jul 23.

Reasons for undergoing amyloid imaging among diverse enrollees in the A4 study

Christina M Magana-Ramirez  1 , Gimarie Irizarry-Martinez  2 , Daniel L Gillen  1   3   4 , Joshua D Grill  2   3   4   5
Affiliations

Reasons for undergoing amyloid imaging among diverse enrollees in the A4 study

Christina M Magana-Ramirez et al. Alzheimers Dement. 2024 Sep.

Abstract

Introduction: Understanding attitudes toward participation among diverse preclinical Alzheimer's disease (AD) trial participants could yield insights to instruct future recruitment.

Methods: Using data from the Anti-Amyloid Treatment in Asymptomatic AD (A4) Study, we examined differences among mutually exclusive racial and ethnic groups in views and perceptions of amyloid imaging (VPAI), a measure of motivations to undergo amyloid biomarker testing in the setting of preclinical AD. We used linear regression to quantify differences at baseline.

Results: Compared to non-Hispanic or Latino (NH) White participants, Hispanic or Latino (3.52 points, 95% confidence interval [CI]: [2.61, 4.42]); NH Asian (2.97 points, 95% CI: [1.71, 4.22]); and NH Black participants (2.79 points, 95% CI: [1.96, 3.63]) participants demonstrated higher levels of endorsement of the VPAI items at baseline.

Discussion: Differences may exist among participants from differing ethnic and racial groups in motivations to undergo biomarker testing in the setting of a preclinical AD trial.

Highlights: Representative samples in AD clinical trials are vital to result in generalizability. We assessed motivations to undergo amyloid imaging in a preclinical AD trial. Racial and ethnic minority groups showed higher endorsement of VPAI items. Differences were driven by perceived risk, plan/prepare, and curiosity domains. Few observations among racial and ethnic groups changed after biomarker disclosure.

Keywords: disclosure; diversity; preclinical; recruitment.

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Conflict of interest statement

Dr. Grill has received funding from the NIA, Alzheimer's Association, BrightFocus Foundation, Eli Lilly, Biogen, Genentech, and Eisai. He has provided paid consultation to SiteRx, Cogniciti, and Flint Rehab. Dr. Gillen, Magana‐Ramirez, Irizarry‐Martinez report no conflicts of interest. Author disclosures are available in the Supporting Information.

Figures

FIGURE 1
FIGURE 1
Pre‐disclosure mean difference and distributions. Estimated regression estimates of pre‐disclosure key secondary outcomes (left panels) qualifying the associations between mutually exclusive race and ethnicity groups and domain‐specific scores of perceived risk (A), altruism/contribute to research (B), plan and prepare (C), and curiosity (D). The estimate is illustrated by a point which represents the average domain score difference of the mutually exclusive race and ethnicity groups relative to the reference group (NH White participants) and its corresponding uncertainty is illustrated by the horizontal lines which represent the 95% confidence interval. Additionally, distributions of domain scores for perceived risk (E), altruism/contribute to research (F), plan and prepare (G), and curiosity (H) with fitted density curves corresponding to mutually exclusive race and ethnicity groups (right panels). HL, Hispanic or Latino; NH, non‐Hispanic or Latino.
FIGURE 2
FIGURE 2
Post‐disclosure change in score. Estimated regression estimates of post‐disclosure key secondary outcomes qualifying the associations between mutually exclusive race and ethnicity groups and change of domain‐specific scores (visit 3 domain score–visit 1 domain score) of perceived risk (A, E), altruism/contribute to research (B, F), plan and prepare (C, G), and curiosity (D, H) stratified by biomarker result. The estimate is illustrated by the point which represents the estimated difference in the change of domain score of the mutually exclusive race and ethnicity groups relative to the reference group (NH White participants), and its corresponding uncertainty is illustrated by the horizontal lines which represent the 95% confidence interval. HL, Hispanic or Latino; NH, non‐Hispanic or Latino.
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