INDIANAPOLIS — In a new Alzheimer's disease-related initiative, Indiana University School of Medicine researchers have begun using PET brain scans to look for signs of abnormal protein deposits known as amyloid plaques in older patients who have been diagnosed with mild cognitive problems.

The new project, part of a national research study that will enroll more than 18,000 participants, was made possible by Medicare's decision to reimburse for the amyloid PET brain scans in the study.

The Imaging Dementia – Evidence for Amyloid Scanning Study, known as the IDEAS Study, will use amyloid PET brain scans to determine whether participants have abnormal deposits of amyloid proteins in the brain, which are closely associated with Alzheimer's disease. The IDEAS Study is led by the Alzheimer’s Association and managed by the American College of Radiology and American College of Radiology Imaging Network.

Although imaging technologies to identify amyloid deposits in the brain have been available for several years, Medicare — the federal government’s health insurance program for Americans age 65 and older — has decided only to cover the scans in the context of this study in order to learn more about the impact of amyloid PET brain scans before making a final decision on coverage for Medicare beneficiaries who may benefit from the scan.

The research goal of the IDEAS Study is to determine whether knowing that patients have the amyloid deposits will change physicians' treatment plans for those patients. Researchers will also gauge after 12 months whether this knowledge had an effect on hospitalizations and emergency room visits.

At least 200 participants will be enrolled at the IU School of Medicine and IU Health, said Liana Apostolova, M.D., Barbara and Peer Baekgaard Professor of Alzheimer's Disease Research and principal investigator for the research study at IU.

Participants must be age 65 or older and have been diagnosed as having mild cognitive impairment or other objective measures of cognitive decline. The participants may be referred to the trial by any physician, but IU dementia specialists will make the final determination of who qualifies for the trial. As with any medical service covered by Medicare, participants will be responsible for any deductible or co-payment required for the service. The actual amount that the individual will pay will depend on their Medicare plan.

Dr. Apostolova said that adding brain amyloid PET scans to the physician's standard toolset would have numerous benefits, starting with more accurate diagnoses — some patients with mild cognitive impairment or other forms of dementia are now misdiagnosed as having Alzheimer’s disease. Information from amyloid PET brain scans could help exclude underlying Alzheimer’s disease, and may help guide patient management.

In turn, accurate diagnoses may reduce unnecessary diagnostic tests and inappropriate treatments, may encourage better planning and financial decisions by patients and their families, and may also reduce costs. With an accurate diagnosis, patients can receive more precise and suitable education in order to better prepare for the future.

Because of growing evidence that the initial stages of Alzheimer's begin years, even decades before symptoms of the disease appear, many researchers are focusing their efforts on identifying people with biomarkers — such as increased amyloid protein deposits — that put them at increased risk of developing the disease. Such people could be placed on regimens meant to delay or prevent the disease – once they are developed and proven – much like statins, dietary changes and exercise are prescribed to reduce the risk of heart attacks.

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