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

Autor:	Roth S; Roche Diagnostics International Ltd, Rotkreuz, Switzerland., Burnie N; General Practice, South West London CCG, London, UK., Suridjan I; Roche Diagnostics International Ltd, Rotkreuz, Switzerland., Yan JT; Roche Diagnostics, Santa Clara, CA, USA., Carboni M; Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
Jazyk:	angličtina
Zdroj:	Journal of Alzheimer's disease reports [J Alzheimers Dis Rep] 2023 Jun 29; Vol. 7 (1), pp. 659-674. Date of Electronic Publication: 2023 Jun 29 (Print Publication: 2023).
DOI:	10.3233/ADR230007
Abstrakt:	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. Competing Interests: MC, IS, and SR are full-time employees of Roche Diagnostics International Ltd, Rotkreuz, Switzerland, and receive salaries. JY is a full-time employee of Roche Diagnostics, Santa Clara, CA, US, and receives a salary. NB has no conflicts of interest to disclose. (© 2023 – The authors. Published by IOS Press.)
Databáze:	MEDLINE
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