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Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries
BACKGROUND: Diagnostic pathways for patients presenting with cognitive complaints may vary across geographies. OBJECTIVE: To describe diagnostic pathways of patients presenting with cognitive complaints across 6 countries. METHODS: This real-world, cross-sectional study analyzed chart-extracted data...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357118/ https://www.ncbi.nlm.nih.gov/pubmed/37483324 http://dx.doi.org/10.3233/ADR230007 |
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author | Roth, Sophie Burnie, Nerida Suridjan, Ivonne Yan, Jessie T. Carboni, Margherita |
author_facet | Roth, Sophie Burnie, Nerida Suridjan, Ivonne Yan, Jessie T. Carboni, Margherita |
author_sort | Roth, Sophie |
collection | PubMed |
description | BACKGROUND: Diagnostic pathways for patients presenting with cognitive complaints may vary across geographies. OBJECTIVE: To describe diagnostic pathways of patients presenting with cognitive complaints across 6 countries. METHODS: This real-world, cross-sectional study analyzed chart-extracted data from healthcare providers (HCPs) for 6,744 patients across China, France, Germany, Spain, UK, and the US. RESULTS: Most common symptoms at presentation were cognitive (memory/amnestic; 89.86%), followed by physical/behavioral (87.13%). Clinical/cognitive tests were used in > 95%, with Mini-Mental State Examination being the most common cognitive test (79.0%). Blood tests for APOE ɛ4/other mutations, or to rule out treatable causes, were used in half of the patients. Clinical and cognitive tests were used at higher frequency at earlier visits, and amyloid PET/CSF biomarker testing at higher frequency at later visits. The latter were ordered at low rates even by specialists (across countries, 5.7% to 28.7% for amyloid PET and 5.0% to 27.3% for CSF testing). Approximately half the patients received a diagnosis (52.1% of which were Alzheimer’s disease [AD]). Factors that influenced risk of not receiving a diagnosis were HCP type (higher for primary care physicians versus specialists) and region (highest in China and Germany). CONCLUSION: These data highlight variability in AD diagnostic pathways across countries and provider types. About 45% of patients are referred/told to ‘watch and wait’. Improvements can be made in the use of amyloid PET and CSF testing. Efforts should focus on further defining biomarkers for those at risk for AD, and on dismantling barriers such low testing capacity and reimbursement challenges. |
format | Online Article Text |
id | pubmed-10357118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-103571182023-07-21 Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries Roth, Sophie Burnie, Nerida Suridjan, Ivonne Yan, Jessie T. Carboni, Margherita J Alzheimers Dis Rep Research Report BACKGROUND: Diagnostic pathways for patients presenting with cognitive complaints may vary across geographies. OBJECTIVE: To describe diagnostic pathways of patients presenting with cognitive complaints across 6 countries. METHODS: This real-world, cross-sectional study analyzed chart-extracted data from healthcare providers (HCPs) for 6,744 patients across China, France, Germany, Spain, UK, and the US. RESULTS: Most common symptoms at presentation were cognitive (memory/amnestic; 89.86%), followed by physical/behavioral (87.13%). Clinical/cognitive tests were used in > 95%, with Mini-Mental State Examination being the most common cognitive test (79.0%). Blood tests for APOE ɛ4/other mutations, or to rule out treatable causes, were used in half of the patients. Clinical and cognitive tests were used at higher frequency at earlier visits, and amyloid PET/CSF biomarker testing at higher frequency at later visits. The latter were ordered at low rates even by specialists (across countries, 5.7% to 28.7% for amyloid PET and 5.0% to 27.3% for CSF testing). Approximately half the patients received a diagnosis (52.1% of which were Alzheimer’s disease [AD]). Factors that influenced risk of not receiving a diagnosis were HCP type (higher for primary care physicians versus specialists) and region (highest in China and Germany). CONCLUSION: These data highlight variability in AD diagnostic pathways across countries and provider types. About 45% of patients are referred/told to ‘watch and wait’. Improvements can be made in the use of amyloid PET and CSF testing. Efforts should focus on further defining biomarkers for those at risk for AD, and on dismantling barriers such low testing capacity and reimbursement challenges. IOS Press 2023-06-29 /pmc/articles/PMC10357118/ /pubmed/37483324 http://dx.doi.org/10.3233/ADR230007 Text en © 2023 – The authors. Published by IOS Press https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) License (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Report Roth, Sophie Burnie, Nerida Suridjan, Ivonne Yan, Jessie T. Carboni, Margherita Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title | Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title_full | Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title_fullStr | Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title_full_unstemmed | Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title_short | Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries |
title_sort | current diagnostic pathways for alzheimer’s disease: a cross-sectional real-world study across six countries |
topic | Research Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357118/ https://www.ncbi.nlm.nih.gov/pubmed/37483324 http://dx.doi.org/10.3233/ADR230007 |
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