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Alzheimers Dement. 2015 May;11(5):523-32. doi: 10.1016/j.jalz.2014.05.1753. Epub 2014 Aug 22.

Diagnostic impact of CSF biomarkers for Alzheimer's disease in a tertiary memory clinic.

Author information

1
Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: f.duits@vumc.nl.
2
Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
3
Department of Clinical Chemistry, Neurochemistry Laboratory and Biobank, VU University Medical Center, Amsterdam, The Netherlands.
4
Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

We aimed to assess the impact of cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease on decision making and patient management in a tertiary memory clinic.

METHODS:

We included all patients, for 1 year, visiting the VUmc Alzheimer Center for cognitive screening. Neurologists completed questionnaires before and after CSF disclosure. We assessed the change of diagnosis, diagnostic confidence, and impact on patient management.

RESULTS:

A total of 438 patients (age 63 ± 8 years, 39% women) were included, of whom 351 (80%) underwent lumbar puncture. After the disclosure of CSF 23/351 diagnoses (7%) were changed. Diagnostic confidence increased from 84% to 89% (P < .001). There were consequences for management in 44/351 patients (13%) with CSF, and 13/87 patients (15%) because of unavailable CSF. There was no effect of age on these results.

CONCLUSIONS:

CSF biomarkers aid clinicians with decision making during diagnostic work-up of cognitive disorders. This study may be useful for developing guidelines for the implementation of CSF biomarkers in daily practice.

KEYWORDS:

Alzheimer's disease; Amyloid-β(1–42); Assessment of cognitive disorders; Biomarkers; Cerebrospinal fluid; Clinical practice; Dementia; Diagnostic impact; Tau

PMID:
25156643
DOI:
10.1016/j.jalz.2014.05.1753
[Indexed for MEDLINE]

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