Early PET to diagnose Alzheimer's correlates with better outcomes

Early findings from the Metabolic Cerebral Imaging in Incipient Dementia study show that patients with symptoms of Alzheimer's disease who are diagnosed early with PET imaging start receiving treatment earlier and show better clinical outcomes.

The study is an ongoing effort by the Centers for Medicare & Medicaid Services. Interim data from the study show that patients diagnosed with the help of a brain PET scan performed with FDG responded better over a two-year period than patients of doctors who didn't have access to PET scan information.

"The patients whose doctors were made aware of the Alzheimer's disease metabolic pattern in their brains received Alzheimer's therapies sooner, and did better than patients whose doctors did not have the benefit of that information," principal investigator Daniel Silverman, a UCLA professor of molecular and medical pharmacology, said in an announcement. "During the subsequent two years after their PET scans, these patients had superior executive function, better memory abilities and greater preservation of overall cognitive function, providing the first direct evidence that patients whose early Alzheimer's disease is revealed by FDG-PET will do better than patients with the same condition, but with their brain metabolism pattern remaining unknown to their doctors and themselves."

The findings were presented last week at the Medical Biotech Forum in China.

The results of the study are timely, considering a national Medicare coverage decision on PET scans for patients with signs of cognitive decline is expected this week. CMS issued a draft decision in July that would only narrowly cover beta-amyloid PET imaging for patients only enrolled in specific CMS-approved clinical studies.

According to Silverman, the study demonstrates substantial clinical benefit from earlier PET scans for patients with symptoms of Alzheimer's, which also could lead to substantial savings in healthcare costs.

"Patients who don't have Alzheimer's disease may be prescribed drugs that won't help them, or even make them worse," Silverman said. "And each year of taking these medications costs hundreds of dollars more than the reimbursement for a PET scan would."

In addition, Silverman argued, diagnosing and treating Alzheimer's patients earlier would delay their cognitive declines and delay the necessity of placing them in nursing homes.

"With nursing home care costing an average of about $7,000 a month, there is the potential for CMS and American taxpayers to save several billion dollars per year," he said.

To learn more:
- read the UCLA announcement

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