Background: Maintaining high continuity of care (COC) is crucial for improved health outcomes, especially among older adults. However, it remains unclear how amyloid-β PET scans affect COC for individuals diagnosed with mild cognitive impairment (MCI) or dementia of uncertain origin. This study investigates the impact of these scans on COC within this specific patient group.
Methods: This research utilized data from the CARE-IDEAS study, which examined the effects of amyloid-β PET scans on Medicare beneficiaries with MCI or dementia and their caregivers. Linked to Medicare claims data from 2015 to 2018, the study calculated a participant-level COC index using the Bice-Boxerman formula. This index was based on ambulatory evaluation and management visits in the year before and after the amyloid-β PET scan. Baseline characteristics were compared between patients with elevated and non-elevated scan results using standardized differences. Multiple regression models, adjusted for factors like sociodemographics, cognitive function, general health, and the Charlson Comorbidity Index, were used to assess changes in COC.
Results: The study included 1171 participants with an average age of 75.2 years. The cohort was predominantly male (61.5%) and non-Hispanic white (93.9%). A significant majority (68.1%) showed elevated amyloid-β PET scan results. The average COC score across all patients was 0.154 (SD = 0.102) before the scan and 0.158 (SD = 0.105) after the scan. While there was a slight increase of 0.005 points in the mean COC index score for those with elevated scans compared to those without, this difference was not statistically significant (95% CI: -0.008, 0.019). The study found no significant association between scan results (elevated vs. not elevated) or other patient factors and changes in COC scores following the scan.
Conclusion: The receipt of amyloid-β PET scans did not result in a meaningful change in continuity of care for Medicare beneficiaries with MCI or dementia of uncertain etiology. Further research is necessary to understand how care continuity is affected within diverse and potentially marginalized populations experiencing cognitive impairment. Future studies should focus on identifying factors that can improve continuity of care in these vulnerable groups.
