Analyzing the future time perspective scale in the baseline period in the Anti‐Amyloid treatment in Asymptomatic Alzheimer's Disease (A4) Study

Abstract

AbstractBackgroundLearning an Alzheimer’s disease (AD) biomarker result can impact a person’s expectations for their future. We assessed the behavior of the Future Time Perspective (FTP) scale in a sample of cognitively unimpaired older adults undergoing AD biomarker testing and disclosure.Method5665 participants who were screened for a multisite randomized preclinical AD trial learned their result of an amyloid PET scan: 1182 elevated and 3310 not elevated. Each completed the FTP scale before and after learning the result. The FTP is a 10‐item scale that measures perceived remaining time. Items are rated on a 7‐point scale. Correlations, factor analysis, within‐subject comparisons, and polytomous analyses explored relationships between FTP and amyloid status. In multinomial logistic regression (MLR) analyses, the base outcome was no FTP change (50th%tile interquartile range of change score distribution). Decreased FTP was the lowest quartile of change score distribution while increased FTP was the upper quartile.ResultsUsing items that showed high uniqueness scores (<0.40) and low ceiling effects (<20% endorsing maximum scale scores), we examined a 3‐item FTP subscale (FTP‐3, score range 1 to 7). Mean change in persons with elevated amyloid was 0.12 (95%CI 0.06 to 0.18) and 0.20 (95%CI 0.17 to 0.24) in those with a not elevated result.In MLR analysis, the mean in the decreased FTP‐3 group was ‐0.89 points (95%CI ‐0.92 to ‐0.86), while the mean increased FTP‐3 was 1.26 (95%CI 1.22 to 1.29). Elevated amyloid results (0.22, 95%CI 0.06 to 0.39) and better self‐rated cognitive function (CFI, ‐0.03, 95%CI ‐0.05 to 0.01) made decreased FTP‐3 more likely than no FTP‐3 change. In the same analysis, lower MMSE scores (‐0.08, 95%CI ‐0.14 to ‐0.03) made increased FTP‐3 more likely than no FTP‐3 change.ConclusionThe 3‐item FTP scale offers an option for a brief measure with limited ceiling effects. Additionally, while mean FTP change due to AD biomarker result disclosure is small (mean=0.18), our findings from polytomous analysis support the hypothesis that AD biomarker result knowledge may have notable effects on FTP (∼2SD). FTP warrants further study in preclinical AD with attention to associations with disease progression, well‐being, and life plans.