Current diagnostic pathways for Alzheimer's Disease ‐ A comparison of six countries

Abstract

BackgroundDiagnostic pathways from cognitive impairment (CI) to Alzheimer’s disease (AD) are complex and vary geographically. This study aimed to quantify and compare the current diagnostic pathways in six countries.MethodsA real‐world, cross‐sectional survey of 1,694 health care professionals (HCPs) was conducted in six countries (US, China, UK, France, Germany and Spain) from October to November 2021. HCPs provided data for 6,744 patients including patient demographics, presenting symptoms, and diagnostic tests and procedures. Descriptive analyses were conducted for all patients and further stratified by countries and HCP types (primary care physicians (PCP) versus specialists (geriatricians, neurologists and psychiatrists)).ResultsMost common presenting symptoms included problems with memory (89.9%), physical/behavioral (87.1%), executive functioning (72.2%) and language (71.4%). 42.1% of patients were presenting to HCPs the first time for their symptoms.96.0% of patients with data on diagnostic tests by country and specialty (n=6,525), underwent clinical and 95.5% cognitive tests, including tests at scheduled follow‐up visits. Mini‐Mental State Examination (MMSE) was the most frequently used cognitive test (n=5,141). About half the patients (n=3,329) received blood‐tests, mainly to rule out other causes of CI (n=2,687) (Table 1).Diagnostic test use varied by country and specialty. In China, cognitive tests, especially MMSE, were more commonly used by specialists (81.9%) than PCPs (41.6%). In the UK blood tests were more commonly used by PCPs (62.5%) than specialists (46.2%).ConclusionDiagnostic pathways varied largely by country and specialty. This study is relevant to populate diagnostic pathways, fill data gaps and advance patient care in AD by supporting future evidence generation, especially when new treatment options arrive.

Current Diagnostic Pathways for Alzheimer’s Disease: A Cross-Sectional Real-World Study Across Six Countries

“…This study [24] is based on 1) a comprehensive quantitative physician online survey, conducted by Hall and Partners (UK) on behalf of Roche Diagnostics International; 2) patient data extracted by the responding physicians into patient record forms (PRFs). Similar methods have been used in earlier studies [25][26][27][28].…”

The potential clinical value of plasma biomarkers in Alzheimer's disease

“…Globally, there is no standardized AD diagnostic pathway 6 . At present, symptomatic individuals with clinical suspicion of AD undergo a combination of clinical history taking, cognitive assessments, routine laboratory tests (e.g., blood and/or urine tests), and structural brain imaging (e.g., computed tomography or magnetic resonance imaging [MRI]) to rule out other causes of cognitive complaints or impairment 7 .…”