Adoption of Alzheimer's disease biomarkers by primary care clinicians: findings from the National Dementia Workforce Study.

INTRODUCTION

Biomarkers for Alzheimer's disease (AD) are now available for clinical use; however, little is known about their use in primary care.

METHODS

Cross-sectional analysis of 2024 data from the National Dementia Workforce Study, a nationally representative survey of primary care providers (PCPs) who treat Medicare beneficiaries with dementia. We used survey weights to generate nationally representative estimates of self-reported biomarker use.

RESULTS

Among 2574 PCPs, computed tomography/magnetic resonance imaging (CT/MRI) (79%) and neuropsychological testing (71%) were most commonly used, followed by positron emission tomography (PET) (18%), plasma (16%), genetic (14%), and CSF testing (9%). PCPs confident in diagnosing dementia and from specialist settings were more likely to report ordering PET, plasma, genetic, and CSF testing.

DISCUSSION: This study describes patterns in the adoption of AD biomarkers in the year after Medicare expanded coverage for some biomarkers, providing a baseline for measuring changes in biomarker use. Guidelines are needed to inform PCP decision-making for biomarkers.