Clinical utility and applicability of biomarker-based diagnostic criteria for Alzheimer’s disease: a BeDeCo survey

• DOI: 10.1007/s13760-014-0423-7
• Publication Date: 2015-01-09T06:42:03Z
• Authors: Jean-Christophe Bier; Jurn Verschraegen; Rik Vandenberghe; Bénédicte Guillaume; Gaëtane Picard; Georges Otte; Eric Mormont; Christian Gilles; Kurt Segers; Anne Sieben; Evert Thiery; Manfredi Ventura; Peter De Deyn; Olivier Deryck; Jan Versijpt; Eric Salmon; Sebastiaan Engelb...; Adrian Ivanoiu
• Keywords: Diagnostic Imaging; Male; Cognitive Dysfunction -- diagnosis; Diagnosis criteria; 03 medical and health sciences; 0302 clinical medicine; Belgium; Alzheimer Disease; Neurologie; Humans; Biomarkers -- metabolism; Cognitive Dysfunction; Survey; Retrospective Studies; Medicine -- standards; Alzheimer Disease -- diagnosis -- metabolism; Health Surveys; 3. Good health; Expert opinion; Diagnostic Imaging -- methods -- standards; Medicine; Female; Alzheimer disease; Biomarkers

We conducted a survey regarding the medical care of patients with dementia in expert settings in Belgium. Open, unrestricted and motivated answers were centralized, blindly interpreted and structured into categories. The report of the results was then submitted to the participants in subsequent plenary meetings and through email. Fourteen experts responded to the questionnaire, confirming that recent propositions to modify Alzheimer's disease (AD) diagnostic criteria and options have stirred up debate among well-informed and dedicated experts in the field. The opinions were not unanimous and illustrate how difficult it is to find a standardized method of diagnosing this disease. The responses to the survey suggest that application of a step-by-step pragmatic method is used in practice. Only when the combination of clinical findings and classical structural neuro-imaging is insufficient for a diagnosis or suggests an atypical presentation, additional biomarkers are considered. Interestingly, few differences, if any, were observed between the use of biomarkers in MCI and in AD. In conclusion, the Belgian experts consulted in this survey were generally in agreement with the new diagnostic criteria for AD, although some concern was expressed about them being too "amyloidocentric". Although the clinical examination, including a full neuropsychological evaluation, is still considered as the basis for diagnosis, most experts also stated that they use biomarkers to help with diagnosis.