By Chloe Elmer
New technologies can help secure a more definitive diagnosis of Alzheimer’s disease but may not yet be available to the average person.
Imaging Dementia—Evidence for Amyloid Scanning — the IDEAS study — is testing whether the amyloid PET scan should be made available to Medicare patients.
An amyloid PET scan is a type of neuroimaging that can show the deposition and accumulation of amyloid plaques in the brain. These plaques can develop years before symptoms of impairment arise and can cause cell death and tissue loss, two mechanisms researchers believe contribute to the development of Alzheimer’s disease.
The Centers for Medicare & Medicaid Services (CMS) do not provide coverage of amyloid imaging because of a 2013 decision citing insufficient evidence that the imaging is “reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of…Medicare beneficiaries with dementia or neurodegenerative disease.”
IDEAS Study Principal Investigator Dr. Gil D. Rabinovici disagrees with that ruling. The UC San Francisco associate professor said early findings show that clinicians who saw scan data changed medications or recommendations in two-thirds of participants. Clinicians also often modified diagnoses, especially in cases of patients initially diagnosed with Alzheimer’s disease but showing no signs of amyloid plaques.
“In the cases where the cause of a patient’s cognitive impairment is unclear, their use may help exclude underlying Alzheimer’s disease and help guide patient management,” said Rabinovici.
Participants in the IDEAS study must be 65 years of age and older, have been diagnosed with mild cognitive impairment (MCI) or dementia by a dementia specialist after a thorough assessment, and have the root cause of their cognitive decline unknown. Medicare beneficiaries meeting those conditions can participate in this study for 24 months in 200 different sites throughout the country, including at the Penn Memory Center.
If you’re interested in learning more about the IDEAS study, visit www.ideas-study.org.