A systematic review of the impact of amyloid PET scan disclosure on psychological and behavioral outcomes for persons with cognitive impairment and their caregivers
Elyse Couch, Miriam T. Ashford, Wenhan Zang, Matthew Prina- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Background
Amyloid‐β PET scans are a potentially useful diagnostic tool, however there is limited understanding of the impact of amyloid disclosure on persons with cognitive impairment and their caregivers. This study aimed to systematically review the impact of amyloid scan disclosure on patient and caregiver psychological and behavioral outcomes.
Method
We searched Medline, Embase and PsychInfo to identify relevant articles. Studies of any design including persons with subjective cognitive impairment, MCI and dementia and their caregivers were included. Outcomes were limited to psychological and behavioral outcomes recorded following disclosure. All articles were screened for eligibility by two reviewers.
Result
We identified 9 papers from 6 studies. Depression, anxiety and test‐related distress were the most common psychological outcomes and recall and knowledge of the scan result were the most common behavioral outcomes. The psychological impact of amyloid disclosure varied depending on the scan recipient’s level of impairment and scan result. Higher test related distress was observed in persons with MCI and elevated amyloid and higher levels of anxiety were found in their caregivers. Most persons with cognitive impairment and their caregivers were able to recall the scan result. However, one study found that gains in knowledge regarding the scan recipients diagnosis following disclosure were comparable to receiving psychoeducation.
Conclusion
Psychological responses to amyloid PET scan disclosure depends on the recipient’s level of impairment and the scan result itself. Persons with MCI and a positive scan result, and their caregivers were at greater risk of distress or anxiety and may benefit from additional post‐diagnostic support. Participants were able to correctly recall their scan results and reported an increase in knowledge regarding their diagnosis. However, psychoeducation may be equally effective at enhancing patient and caregiver knowledge, at a lower cost.