Amyloid PET and clinical management in a diverse, cognitively impaired population: The New IDEAS Study

Charles C Windon¹, Constantine Gatsonis^{2

3}, Maria C Carrillo⁴, Justin Romanoff², Lucy Hanna², Emily Glavin⁵, Ilana Gareen^{2

6}, Roee Gutman^{2

3}, Bruce E Hillner⁷, Andrew March⁵, Sid O'Bryant^{8

9}, Robert A Rissman¹⁰, Barry A Siegel¹¹, Karen Smith¹, Rachel A Whitmer^{12

13}, Christopher J Weber⁴, Consuelo H Wilkins¹⁴, Peggye Dilworth-Anderson¹⁵, Gil D Rabinovici^{1

16}

Affiliations

¹ Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.
² Center for Biostatistics and Health Data Science, Brown University School of Public Health, Providence, Rhode Island, USA.
³ Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.
⁴ Alzheimer's Association, Chicago, Illinois, USA.
⁵ Center for Research and Innovation, American College of Radiology, Reston, Virginia, USA.
⁶ Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
⁷ Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
⁸ Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, Texas, USA.
⁹ Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA.
¹⁰ Department of Physiology and Neuroscience, Alzheimer's Therapeutic Research Institute, Keck School of Medicine of the University of Southern California, San Diego, California, USA.
¹¹ Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
¹² Division of Research, Kaiser Permanente, Oakland, California, USA.
¹³ Department of Public Health Sciences, University of California Davis, Davis, California, USA.
¹⁴ Department of Medicine, Division of Geriatric Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁵ Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹⁶ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.

PMID: 40728069
PMCID: PMC12305457
DOI: 10.1002/alz.70504

Observational Study

Amyloid PET and clinical management in a diverse, cognitively impaired population: The New IDEAS Study

Charles C Windon et al. Alzheimers Dement. 2025 Jul.

. 2025 Jul;21(7):e70504.

doi: 10.1002/alz.70504.

Authors

Affiliations

¹ Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.
² Center for Biostatistics and Health Data Science, Brown University School of Public Health, Providence, Rhode Island, USA.
³ Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.
⁴ Alzheimer's Association, Chicago, Illinois, USA.
⁵ Center for Research and Innovation, American College of Radiology, Reston, Virginia, USA.
⁶ Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
⁷ Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
⁸ Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, Texas, USA.
⁹ Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA.
¹⁰ Department of Physiology and Neuroscience, Alzheimer's Therapeutic Research Institute, Keck School of Medicine of the University of Southern California, San Diego, California, USA.
¹¹ Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
¹² Division of Research, Kaiser Permanente, Oakland, California, USA.
¹³ Department of Public Health Sciences, University of California Davis, Davis, California, USA.
¹⁴ Department of Medicine, Division of Geriatric Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁵ Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹⁶ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.

PMID: 40728069
PMCID: PMC12305457
DOI: 10.1002/alz.70504

Abstract

Introduction: The New Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study (NCT04426539) evaluated the association between amyloid positron emission tomography (PET) and changes in clinical management among ethnoracially diverse, clinically heterogeneous patients.

Methods: We assessed diagnosis and management plan before and 90 ± 30 days after amyloid PET among Medicare beneficiaries who met 2018 National Institute on Aging-Alzheimer's Association criteria for mild cognitive impairment (MCI) or dementia. We aimed to identify ≥ 30% change in a composite patient management endpoint (CPME; i.e., changes in Alzheimer's disease [AD]/non-AD medications, changes in counseling).

Results: Among 5757 participants (median age 75 years; 21.7% Black, 20.3% Latinx, 58.1% all other races/ethnicities [AORE]), a change in CPME occurred in 59.0% (95% confidence interval 57.6%-60.5%) of individuals post PET. Change varied by ethnoracial identity and type of clinical presentation: Black (MCI: 55.3%, dementia: 55.8%), Latinx (MCI: 53.7%, dementia: 61.9%), AORE (MCI: 62.0%, dementia: 58.3%), typical (MCI: 64.8%, dementia: 60.9%), atypical (MCI 45.5%, dementia: 53.6%).

Discussion: Amyloid PET is associated with clinical management among diverse, clinically heterogeneous populations.

Highlights: Changes in management plan occurred in 59% of patients 90 days after amyloid positron emission tomography. Rates of change in management exceeded the pre-specified goal of > 30% across ethnoracial groups. Rates of change in management also exceeded > 30% among amnestic and non-amnestic Alzheimer's disease presentations.

Keywords: Alzheimer's disease; Medicare; amyloid positron emission tomography; dementia; ethnicity; mild cognitive impairment.

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Conflict of interest statement

CCW reports receiving grants from the Alzheimer's Association and the NIA. He has received honorariums from LCN, Kinetix Group, and Onviv Inc. CG and BEH report support from the American College of Radiology. JR, LH, and KS were supported by the American College of Radiology through institutional funding. MCC is a full‐time employee of the Alzheimer's Association. EG and AM are salaried employees of the American College of Radiology. IFG and RG report support from the Alzheimer's Association and the American College of Radiology. RAR reports research support from the National Institute on Aging and the Alzheimer's Association and is a consultant for Amydis Inc, Bioivt, Lexeo, Keystone Bio, Allyx, DiamiR, Ionis, and PrecisionMed. BAS reports receiving grants to institution from the American College of Radiology (ACR) during the conduct of the study; personal fees from Avid Radiopharmaceuticals, Curium Pharma, Progenics Pharmaceuticals, Lantheus Medical Imaging, the American Medical Foundation for Peer Review and Education, Siemens Healthineers (for spouse), ACR (also for spouse), Capella Imaging, ECOG‐ACRIN Medical Research Foundation (also for spouse), Evicore Healthcare (for spouse), GE Healthcare, and Radiological Society of North America (also for spouse) outside the submitted work; and grants from Curium Pharma, Progenics Pharmaceuticals, ImaginAb, and Blue Earth Diagnostics outside the submitted work. RAW reports grants from the NIH and NIA and consulting fees from Genentech PanNeuro. She is the epidemiology section editor for Alzheimer's and Dementia. CJW is a full‐time employee of the Alzheimer's Association. CHW reports grants from the NIH, PCORI, and the American College of Radiology. GDR received research support from Genentech. He has served as a paid scientific consultant for Alector, Bristol Myers Squibb, C2N, Avid Radiopharmaceuticals, Eli Lilly, Johnson & Johnson, Merck, Novo Norodisk, Roche. He is an associate editor for JAMA and JAMA Neurology. All other authors report no conflicts of interest relevant to this work. Author disclosures are available in the supporting information.

Figures

**FIGURE 1**
Participant flowchart. PET, positron emission tomography.

See this image and copyright information in PMC

References

1. Beach TG, Monsell SE, Phillips LE, Kukull W. Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005‐2010. J Neuropathol Exp Neurol. 2012;71:266‐273. - PMC - PubMed
1. Weissberger GH, Strong JV, Stefanidis KB, Summers MJ, Bondi MW, Stricker NH. Diagnostic Accuracy of Memory Measures in Alzheimer's Dementia and Mild Cognitive Impairment: a Systematic Review and Meta‐Analysis. Neuropsychol Rev. 2017;27:354‐388. - PMC - PubMed
1. Dubois B, Villain N, Frisoni GB, et al. Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group. Lancet Neurol. 2021;20:484‐496. - PMC - PubMed
1. Frisoni GB, Boccardi M, Barkhof F, et al. Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers. Lancet Neurol. 2017;16:661‐676. - PubMed
1. Ketchum FB, Chin NA, Grill JD. Aligning Alzheimer Disease Biology With Care. JAMA Neurol. 2025. - PubMed

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Amyloid PET and clinical management in a diverse, cognitively impaired population: The New IDEAS Study

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Amyloid PET and clinical management in a diverse, cognitively impaired population: The New IDEAS Study

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