Implementation of a blood test for Alzheimer's disease in primary care: A pilot study

Abstract

INTRODUCTION: Blood biomarker (BBM) tests could improve early detection of Alzheimer's disease (AD), but their acceptability and feasibility in primary care (PC) are unclear. METHODS: A BBM for AD pathology was offered to patients who screened positive for cognitive impairment in PC. Feasibility and acceptability were measured through rates of patient and provider consent and outcomes were assessed at 1 and 12 months post-disclosure. RESULTS: Two hundred thirty-six patients were approached, 26 (22%) consented to BBM; 24 completed disclosures. BBM results showed 58% low, 7.7% intermediate, and 34.6% high likelihood of amyloid pathology. There were no changes in anxiety, depression, or distress at 1 month post disclosure. At 12 months, 5 (19.2%) were diagnosed with mild cognitive impairment, 3 (11.5%) with AD. Among 31 eligible PC providers, 53% consented to disclosure training and 26% completed disclosure. DISCUSSION: BBM testing in PC is feasible but had limited uptake. Strategies to improve engagement are needed for implementation. Highlights: This pilot study evaluated the use of a blood test for diagnosing Alzheimer's disease in primary care. Engagement with testing was limited in this real-world setting. Testing was feasible and psychologically safe for patients. Future work should focus on strategies to improve patient and provider engagement.