Referring physician practices with eligible dementia specialists are welcome to apply for participation in the IDEAS Study. A referring dementia specialist is a physician trained and board-certified in neurology, psychiatry, or geriatric medicine and who devotes a substantial proportion (≥25%) of patient contact time to the evaluation and care of adults with acquired cognitive impairment or dementia.
The New IDEAS study is currently reaching out to dementia specialists in areas identified by our community engagement and recruitment team. If you have not been contacted yet and would like to be considered for inclusion in the study, please send an email to newideas@acr.org.
Participation in New IDEAS requires the submission of a site feasibility questionnaire and subsequent approval by the study. Information about the New IDEAS study will also be disseminated via professional organizations dedicated to neurology, psychiatry, geriatrics, nuclear medicine and radiology.
Access the feasibility questionnaire for referring dementia sites.
Establishing the cause of cognitive impairment is necessary for doctors to make appropriate recommendations, prescribe the correct treatments, and inform patients and families about what to expect in the future. The best way to establish the cause of cognitive impairment is a thorough clinical assessment by a dementia expert, an evaluation that typically includes blood tests and a brain CT or MRI scan.
However, in some cases the diagnosis remains uncertain after such an evaluation, and further knowledge about the presence or absence of brain amyloid could provide valuable additional information. In some cases, a positive amyloid PET scan may confirm the clinical suspicion of Alzheimer’s disease. In such cases, establishing the diagnosis will help doctors initiate medications approved for the treatment of the disease. Furthermore, doctors will be able to make informed recommendations about the safety of continued employment, driving and independent living — now and in the future.
Patients and caregivers can be referred to the Alzheimer’s Association and other community resources to provide support and assist with future planning.
Studies suggest that, even in lieu of a cure or disease-modifying therapy, most patients seeking a clinical assessment for their cognitive symptoms want to know if the doctor suspects Alzheimer’s disease. Providing patients with the best possible diagnosis adheres to core principles of medical ethics, such as patient autonomy, truth telling, and lack of paternalism.
In other cases, a negative amyloid PET scan would render the diagnosis of Alzheimer’s disease unlikely. This might lead to the diagnosis of an alternative cause of dementia, which may have a different trajectory, prognosis and treatment plan. Doctors would elect to avoid prescribing or discontinue drugs that are effective in Alzheimer’s disease but may be ineffective and potentially even harmful to patients with a different dementia. In some cases, a negative amyloid PET scan might help doctors determine that cognitive impairment is due to a medical condition, mood or sleep disorder, or medication side effect — dramatically altering the prognosis and care plan.
Before enrolling in the New IDEAS study, patients and their doctors should discuss the ramifications of amyloid PET testing and carefully consider how a positive or negative amyloid PET result will impact the care plan as well as the patient’s overall well-being. The scan should not be pursued if it is felt that knowledge of amyloid status will cause significant psychological harm or otherwise negatively impact the patient and family.
Disclosure of the PET scan result and subsequent management recommendations need not wait for the post-PET visit. We hope that clinicians will provide feedback to patients and their families shortly after the scan is read. The post-PET visit then records the patient management implemented by the patient/family.
Two visits are recommended:
To put it in concrete terms: we want to record the actual implemented management at the 90 days post-PET timepoint (e.g., whether someone who was at baseline medication-naïve is actually on a medication), rather than whether it was recommended immediately after the scan (intended management).