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We developed an approach to flag mis\/undocumented ATT in the Longitudinal Early\u2010Onset Alzheimer's Disease Study using longitudinal amyloid positron emission tomography (PET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We analyzed 742 [\n                      <jats:sup>18<\/jats:sup>\n                      F]florbetaben PET from 270 participants with early\u2010onset Alzheimer's disease. Using PET acquired before US Food and Drug Administration (FDA) approval of ATTs, we quantified Centiloid (CL) variability between two consecutive scans (PET \u201csegments\u201d) to determine unusual CL decline thresholds that were then applied to post\u2010FDA approval segments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Pre\u2010FDA approval segments increased by a median of 4.1 CL\/year (whole cerebellum reference) and 3.6 CL\/year (composite reference); unusual CL decline thresholds, defined as mean \u2013 2 standard deviations of the pre\u2010approval distributions were \u221215.8 and \u22129.4 CL\/year, respectively. When applied to segments acquired post\u2010FDA approval, extreme declines were observed in 59% to 78% of treated (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a054) versus 4% to 8% of untreated segments (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0344).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Longitudinal amyloid PET analyses can help identify ATT exposure in observational studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70408","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:50:37Z","timestamp":1782118237000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of patients receiving amyloid\u2010targeting therapies in observational studies using amyloid PET trajectories: Insights from LEADS"],"prefix":"10.1002","volume":"18","author":[{"given":"Renaud","family":"La Joie","sequence":"first","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganna","family":"Blazhenets","sequence":"additional","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyush","family":"Maiti","sequence":"additional","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Chiotis","sequence":"additional","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"},{"name":"Division of Clinical Geriatrics Center for Alzheimer Research Department of Neurobiology, Care Sciences and Society Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ani","family":"Eloyan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Center for Biostatistics and Health Data Science, Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kala","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Neurology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin","family":"Hammers","sequence":"additional","affiliation":[{"name":"Department of Neurology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Koeppe","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah F.","family":"Ackley","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Robison","sequence":"additional","affiliation":[{"name":"Alzheimer's Therapeutic Research Institute University of Southern California  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Soleimani\u2010Meigooni","sequence":"additional","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Carrillo","sequence":"additional","affiliation":[{"name":"Medical &amp; Scientific Relations Division Alzheimer's Association  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford C.","family":"Dickerson","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana G.","family":"Apostolova","sequence":"additional","affiliation":[{"name":"Department of Neurology Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Department of Medical and Molecular Genetics Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Department of Radiology and Imaging Sciences Center for Neuroimaging Indiana University School of Medicine Indianapolis  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil D.","family":"Rabinovici","sequence":"additional","affiliation":[{"name":"Edward and Pearl Fein Memory and Aging Center UCSF Weill Institute for Neurosciences Department of Neurology University of California San Francisco  San Francisco California USA"},{"name":"Department of Radiology &amp; 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