Racial and Ethnic Differences in Amyloid PET Positivity in Individuals With Mild Cognitive Impairment or Dementia: A Secondary Analysis of the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) Cohort Study.
Racial and Ethnic Differences in Amyloid PET Positivity in Individuals With Mild Cognitive Impairment or Dementia: A Secondary Analysis of the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) Cohort Study.
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DOI：
10.1001/jamaneurol.2022.3157
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发表时间：
2022-10-03
期刊：
影响因子：
29
通讯作者：
Rabinovici, Gil D.
中科院分区：
文献类型：
--
作者：
Wilkins, Consuelo H.;Windon, Charles C.;Dilworth-Anderson, Peggye;Romanoff, Justin;Gatsonis, Constantine;Hanna, Lucy;Apgar, Charles;Gareen, Ilana F.;Hill, Carl, V;Hillner, Bruce E.;March, Andrew;Siegel, Barry A.;Whitmer, Rachel A.;Carrillo, Maria C.;Rabinovici, Gil D.
淀粉样蛋白正电子发射断层扫描（PET）阳性率在轻度认知障碍（MCI）或痴呆的种族和民族群体中是否存在差异？在这项对17107名患有MCI或痴呆症的医疗保险受益人的队列研究中，与黑人和亚洲参与者相比，白人参与者中淀粉样蛋白阳性PET扫描的比例更高。当种族和民族群体与社会和人口因素相匹配时，白人参与者的淀粉样蛋白阳性PET扫描比例高于西班牙裔和亚裔参与者，但与黑人参与者相比则没有。本研究结果显示，淀粉样蛋白PET阳性率在种族和民族群体之间存在差异；这些发现可能反映了组间认知障碍潜在病因的差异。这项队列研究评估了轻度认知障碍或痴呆患者的种族差异。临床阿尔茨海默病（AD）发病率较高的种族和民族在阿尔茨海默病生物标志物（包括淀粉样正电子发射断层扫描（PET））的研究中代表性不足。比较轻度认知障碍（MCI）或痴呆个体的不同队列中淀粉样蛋白PET阳性。影像学痴呆-淀粉样蛋白扫描证据（IDEAS）的二次分析，这是一项单臂多地点队列研究，研究对象是2016年2月至2017年9月期间符合淀粉样蛋白PET成像适当使用标准的医疗保险受益人，随访至2018年1月。数据分析时间为2020年4月至2022年1月。本研究使用了两种方法：McNemar测试比较匹配种族和民族之间淀粉样蛋白PET阳性比例，多变量逻辑回归评估淀粉样蛋白PET扫描阳性的几率。IDEAS招募了595名美国痴呆症专科诊所的参与者。共有21949人入组，其中4842人（22%）因违反协议、未接受淀粉样蛋白PET扫描、未进行阳性或阴性扫描或某些亚组中人数较少而被排除在本分析之外。在IDEAS研究中，参与者接受了一次淀粉样蛋白PET扫描。主要结局是淀粉样蛋白PET阳性比例和几率。研究人员分析了2020年4月至2022年1月期间患有MCI或痴呆和淀粉样PET的17 107人（321名亚洲人、635名黑人、829名西班牙裔和15 322名白人）的数据。参与者的年龄中位数（范围）为75岁（65-105岁）；女性8769人（51.3%），男性8338人（48.7%）。在最佳1:1匹配分析（n = 3154）中，白人参与者的淀粉样蛋白PET扫描阳性比例高于亚洲参与者(313人中有181人；57.8%;95% CI, 52.3-63.2 vs 313人中有142人；45.4%;95% CI, 39.9-50.9; P =。001)和西班牙裔参与者(482 / 780;61.8%;95% CI, 58.3-65.1 vs 425 / 780; 54.5%; 95% CI, 51.0-58.0; P =。003)但黑人参与者除外（615人中有359人；58.4%;95% CI, 54.4-62.2 vs 615人中有333人；54.1%;95% CI, 50.2-58.0; P = .13）。在调整后的模型中，亚洲参与者淀粉样蛋白PET扫描阳性的几率较低(优势比[OR]， 0.47; 95% CI, 0.37-0.59; P <。黑人参与者（OR, 0.71; 95% CI, 0.60-0.84; P < 0.001）。001)和西班牙裔参与者（OR, 0.68; 95% CI, 0.59-0.79; P < 0.001）。001)与白人受试者相比。本研究在MCI和痴呆患者中发现的淀粉样蛋白PET阳性的种族和民族差异可能表明认知障碍的潜在病因差异，并指导未来的治疗和预防方法。
Do amyloid positron emission tomography (PET) positivity rates differ across racial and ethnic groups with mild cognitive impairment (MCI) or dementia? In this cohort study of 17 107 Medicare beneficiaries with MCI or dementia, the proportion of amyloid positive PET scans was greater among White participants compared with Black and Asian participants. When racial and ethnic groups were matched by social and demographic factors, the proportion of amyloid positive PET scans was greater among White participants compared with Hispanic and Asian participants but not compared with Black participants. The results of this study showed differences in rates of amyloid PET positivity among racial and ethnic groups; these findings may reflect differences in underlying etiology of cognitive impairment between groups. This cohort study evaluates differences by race and ethnicity in participants with mild cognitive impairment or dementia. Racial and ethnic groups with higher rates of clinical Alzheimer disease (AD) are underrepresented in studies of AD biomarkers, including amyloid positron emission tomography (PET). To compare amyloid PET positivity among a diverse cohort of individuals with mild cognitive impairment (MCI) or dementia. Secondary analysis of the Imaging Dementia–Evidence for Amyloid Scanning (IDEAS), a single-arm multisite cohort study of Medicare beneficiaries who met appropriate-use criteria for amyloid PET imaging between February 2016 and September 2017 with follow-up through January 2018. Data were analyzed between April 2020 and January 2022. This study used 2 approaches: the McNemar test to compare amyloid PET positivity proportions between matched racial and ethnic groups and multivariable logistic regression to assess the odds of having a positive amyloid PET scan. IDEAS enrolled participants at 595 US dementia specialist practices. A total of 21 949 were enrolled and 4842 (22%) were excluded from the present analysis due to protocol violations, not receiving an amyloid PET scan, not having a positive or negative scan, or because of small numbers in some subgroups. In the IDEAS study, participants underwent a single amyloid PET scan. The main outcomes were amyloid PET positivity proportions and odds. Data from 17 107 individuals (321 Asian, 635 Black, 829 Hispanic, and 15 322 White) with MCI or dementia and amyloid PET were analyzed between April 2020 and January 2022. The median (range) age of participants was 75 (65-105) years; 8769 participants (51.3%) were female and 8338 (48.7%) were male. In the optimal 1:1 matching analysis (n = 3154), White participants had a greater proportion of positive amyloid PET scans compared with Asian participants (181 of 313; 57.8%; 95% CI, 52.3-63.2 vs 142 of 313; 45.4%; 95% CI, 39.9-50.9, respectively; P = .001) and Hispanic participants (482 of 780; 61.8%; 95% CI, 58.3-65.1 vs 425 of 780; 54.5%; 95% CI, 51.0-58.0, respectively; P = .003) but not Black participants (359 of 615; 58.4%; 95% CI, 54.4-62.2 vs 333 of 615; 54.1%; 95% CI, 50.2-58.0, respectively; P = .13). In the adjusted model, the odds of having a positive amyloid PET scan were lower for Asian participants (odds ratio [OR], 0.47; 95% CI, 0.37-0.59; P < .001), Black participants (OR, 0.71; 95% CI, 0.60-0.84; P < .001), and Hispanic participants (OR, 0.68; 95% CI, 0.59-0.79; P < .001) compared with White participants. Racial and ethnic differences found in amyloid PET positivity among individuals with MCI and dementia in this study may indicate differences in underlying etiology of cognitive impairment and guide future treatment and prevention approaches.
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DOI：
10.1016/j.trci.2018.08.009
发表时间：
2018
期刊：
Alzheimer's & dementia (New York, N. Y.)
影响因子：
--
作者：
Chen C;Zissimopoulos JM
通讯作者：
Zissimopoulos JM
DOI：
10.1001/jama.2017.3090
发表时间：
2017-04-11
期刊：
JAMA
影响因子：
--
作者：
Gottesman RF;Schneider AL;Zhou Y;Coresh J;Green E;Gupta N;Knopman DS;Mintz A;Rahmim A;Sharrett AR;Wagenknecht LE;Wong DF;Mosley TH
通讯作者：
Mosley TH
影响因子：
9.9
作者：
Frison E;Proust-Lima C;Mangin JF;Habert MO;Bombois S;Ousset PJ;Pasquier F;Hanon O;Paquet C;Gabelle A;Ceccaldi M;Annweiler C;Krolak-Salmon P;Béjot Y;Belin C;Wallon D;Sauvee M;Beaufils E;Bourdel-Marchasson I;Jalenques I;Chupin M;Chêne G;Dufouil C;MEMENTO Cohort Study Group
通讯作者：
MEMENTO Cohort Study Group
影响因子：
9.9
作者：
Deters, Kacie D.;Napolioni, Valerio;Mormino, Elizabeth C.
通讯作者：
Mormino, Elizabeth C.
影响因子：
6
作者：
Firbank, Michael J.;Wiseman, Rebecca M.;Ford, Gary A.
通讯作者：
Ford, Gary A.