Return of Amyloid Imaging Research Results in MCI

描述(申请人提供)：阿尔茨海默病(AD)病理的尸检在认知老化和AD的研究中越来越受欢迎。由于担心来自这类测试的信息可能会被误解，在心理上有害，并且临床意义不明确，AD病理的尸检结果通常对研究参与者隐瞒。然而，随着像大脑淀粉样成像这样的测试的可靠性和潜在的临床意义变得清晰起来，迫切需要重新审视单方面向研究参与者隐瞒此类信息的做法，并确定负责任的方法来传达个人结果。淀粉样蛋白成像结果可能与轻度认知障碍(MCI)特别相关，越来越多的证据表明，尽管没有干预措施改变一个人的临床病程，但这种测试可能提供有价值的预后和规划信息。我们的初步工作表明，当使用我们的跨学科团队开发的标准化方法呈现时，患有MCI的研究参与者及其家人能够接受并能够理解有关淀粉样蛋白成像的目的、结果和意义的信息。在这项工作的基础上，这项拟议的研究由一名针对PA-11-180的早期研究人员领导，将遵循一个具有良好特征的样本，其中至少有40名MCI护理二联体(患者+家庭成员)，以及一组匹配的非二联体，他们可以选择接收患者的淀粉样蛋白成像研究结果。目标1将测试假设，以检验接受淀粉样蛋白成像研究结果将如何影响患者和护理伙伴对MCI的理解和应对的自我效能。目标2将使用一系列定性访谈和内容分析来确定信息和支持 提供淀粉样蛋白成像研究结果的MCI护理二人组的需求。第三个探索性目标将在接受淀粉样蛋白成像研究结果的MCI护理二人组的子组中记录收到此类结果后的心理和行为反应的频率、性质和范围。除了对研究行为有影响外，我们的发现还可能为临床实践提供参考，因为临床医生开始将淀粉样成像纳入临床评估并回应患者对此类成像的请求。

DESCRIPTION (provided by applicant): Pre mortem tests of Alzheimer's disease (AD) pathology are increasingly popular in research on cognitive aging and AD. Due to concerns that information from such tests may be misunderstood, psychologically harmful, and of unclear clinical significance, results of pre mortem tests of AD pathology have typically been withheld from research participants. However, as the reliability and potential clinical significance of test like brain amyloid imaging have become clear, there is a pressing need to revisit the practice of unilaterally withholding such information from research participants and identify responsible approaches to communicating individual results. Amyloid imaging results may be particularly relevant to mild cognitive impairment (MCI), a population for whom a growing body of evidence suggests that such testing may provide valuable prognostic and planning information, despite the unavailability of interventions to alter one's clinical course. Our preliminary work suggests that research participants with MCI and their family members are receptive to and capable of understanding information about the purpose, results, and implications of amyloid imaging when presented using a standardized approach developed by our interdisciplinary team. Building on this work, the proposed study, led by an early stage investigator in response to PA-11-180, will follow a well characterized sample of at least 40 MCI care dyads (patient + family member) who are, and a matched comparison group of dyads who are not, presented with the option of receiving the patient's amyloid imaging research results. Aim 1 will test hypotheses that examine how receiving amyloid imaging research results will impact understanding of, and perceived self-efficacy for coping with, MCI among both patients and care partners. Aim 2 will use a series of qualitative interviews and content analysis to identify the information and support needs of MCI care dyads who are offered amyloid imaging research results. A third, exploratory aim will document, within the subgroup of MCI care dyads who receive amyloid imaging research results, the frequency, nature, and range of psychological and behavioral responses to receiving such results. In addition to having implications for research conduct, our findings may also inform clinical practice as clinicians begin to incorporate amyloid imaging into clinical evaluation and respond to patient requests for such imaging.