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Vuoksimaa E, Saari TT, Aaltonen A, Aaltonen S, Herukka SK, Iso-Markku P, Kokkola T, Kyttälä A, Kärkkäinen S, Liedes H, Ollikainen M, Palviainen T, Ruotsalainen I, Toivola A, Urjansson M, Vasankari T, Vähä-Ypyä H, Forsberg MM, Hiltunen M, Jalanko A, Kälviäinen R, Kuopio T, Lähteenmäki J, Nyberg P, Männikkö M, Serpi R, Siltanen S, Palotie A, Kaprio J, Runz H, Julkunen V. TWINGEN: protocol for an observational clinical biobank recall and biomarker cohort study to identify Finnish individuals with high risk of Alzheimer's disease. BMJ Open 2024; 14:e081947. [PMID: 38866570 PMCID: PMC11177688 DOI: 10.1136/bmjopen-2023-081947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/09/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION A better understanding of the earliest stages of Alzheimer's disease (AD) could expedite the development or administration of treatments. Large population biobanks hold the promise to identify individuals at an elevated risk of AD and related dementias based on health registry information. Here, we establish the protocol for an observational clinical recall and biomarker study called TWINGEN with the aim to identify individuals at high risk of AD by assessing cognition, health and AD-related biomarkers. Suitable candidates were identified and invited to participate in the new study among THL Biobank donors according to TWINGEN study criteria. METHODS AND ANALYSIS A multi-centre study (n=800) to obtain blood-based biomarkers, telephone-administered and web-based memory and cognitive parameters, questionnaire information on lifestyle, health and psychological factors, and accelerometer data for measures of physical activity, sedentary behaviour and sleep. A subcohort is being asked to participate in an in-person neuropsychological assessment (n=200) and wear an Oura ring (n=50). All participants in the TWINGEN study have genome-wide genotyping data and up to 48 years of follow-up data from the population-based older Finnish Twin Cohort (FTC) study of the University of Helsinki. The data collected in TWINGEN will be returned to THL Biobank from where it can later be requested for other biobank studies such as FinnGen that supported TWINGEN. ETHICS AND DISSEMINATION This recall study consists of FTC/THL Biobank/FinnGen participants whose data were acquired in accordance with the Finnish Biobank Act. The recruitment protocols followed the biobank protocols approved by Finnish Medicines Agency. The TWINGEN study plan was approved by the Ethics Committee of Hospital District of Helsinki and Uusimaa (number 16831/2022). THL Biobank approved the research plan with the permission no: THLBB2022_83.
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Affiliation(s)
- Eero Vuoksimaa
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Toni T Saari
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Aino Aaltonen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Sanna-Kaisa Herukka
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Paula Iso-Markku
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Tarja Kokkola
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aija Kyttälä
- THL Biobank, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sari Kärkkäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Liedes
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Ilona Ruotsalainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Auli Toivola
- THL Biobank, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mia Urjansson
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Pirkanmaa, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Pirkanmaa, Finland
| | - Markus M Forsberg
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland Ltd, Kuopio, Finland
| | - Mikko Hiltunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anu Jalanko
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Reetta Kälviäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Teijo Kuopio
- Central Finland Biobank, Wellbeing Services County of Central Finland and University of Jyväskylä, Jyväskylä, Finland
| | | | - Pia Nyberg
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
- Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Minna Männikkö
- Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raisa Serpi
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - Sanna Siltanen
- Finnish Clinical Biobank Tampere, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Heiko Runz
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Translational Sciences, Biogen Inc, Cambridge, Massachusetts, USA
| | - Valtteri Julkunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
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van Gils AM, Rhodius-Meester HFM, Handgraaf D, Hendriksen HMA, van Strien A, Schoonenboom N, Schipper A, Kleijer M, Griffioen A, Muller M, Tolonen A, Lötjönen J, van der Flier WM, Visser LNC. Use of a digital tool to support the diagnostic process in memory clinics-a usability study. Alzheimers Res Ther 2024; 16:75. [PMID: 38589933 PMCID: PMC11003066 DOI: 10.1186/s13195-024-01433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Both memory clinic professionals and patients see value in digital tools, yet these hardly find their way to clinical practice. We explored the usability of a digital tool to support the diagnostic work-up in daily memory clinic practice. We evaluated four modules that integrate multi-modal patient data (1.cognitive test; cCOG, and 2. MRI quantification; cMRI) into useful diagnostic information for clinicians (3. cDSI) and understandable and personalized information for patients (4. patient report). METHODS We conducted a mixed-methods study in five Dutch memory clinics. Fourteen clinicians (11 geriatric specialists/residents, two neurologists, one nurse practitioner) were invited to integrate the tool into routine care with 43 new memory clinic patients. We evaluated usability and user experiences through quantitative data from questionnaires (patients, care partners, clinicians), enriched with thematically analyzed qualitative data from interviews (clinicians). RESULTS We observed wide variation in tool use among clinicians. Our core findings were that clinicians: 1) were mainly positive about the patient report, since it contributes to patient-centered and personalized communication. This was endorsed by patients and care partners, who indicated that the patient report was useful and understandable and helped them to better understand their diagnosis, 2) considered the tool acceptable in addition to their own clinical competence, 3) indicated that the usefulness of the tool depended on the patient population and purpose of the diagnostic process, 4) addressed facilitators (ease of use, practice makes perfect) and barriers (high workload, lack of experience, data unavailability). CONCLUSION This multicenter usability study revealed a willingness to adopt a digital tool to support the diagnostic process in memory clinics. Clinicians, patients, and care partners appreciated the personalized diagnostic report. More attention to education and training of clinicians is needed to utilize the full functionality of the tool and foster implementation in actual daily practice. These findings provide an important step towards a lasting adoption of digital tools in memory clinic practice.
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Affiliation(s)
- Aniek M van Gils
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands.
| | - Hanneke F M Rhodius-Meester
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Dédé Handgraaf
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
| | - Heleen M A Hendriksen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
| | - Astrid van Strien
- Department of Geriatric medicine, Jeroen Bosch Ziekenhuis, Den Bosch, The Netherlands
| | | | - Annemieke Schipper
- Department of Neurology, HagaZiekenhuis, location Zoetermeer, Zoetermeer, The Netherlands
| | - Mariska Kleijer
- Department of Neurology, HagaZiekenhuis, location Zoetermeer, Zoetermeer, The Netherlands
| | - Annemiek Griffioen
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Majon Muller
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | | | | | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Epidemiology and Data Sciences, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Leonie N C Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam/AMC, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Rhodius-Meester HFM, Paajanen T, Lötjönen J. cCOG Web-Based Cognitive Assessment Tool. Methods Mol Biol 2024; 2785:311-320. [PMID: 38427202 DOI: 10.1007/978-1-0716-3774-6_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Cognitive testing is an essential part of clinical diagnostics and clinical trials in Alzheimer's disease. Digital cognitive tests hold a great opportunity to provide more versatile and cost-efficient patient pathways through flexible testing including at home. In this work, we describe a web-based cognitive test, cCOG, that can be used in screening, differential diagnosis, and monitoring the progression of neurodegenerative diseases.
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Affiliation(s)
- Hanneke F M Rhodius-Meester
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
- Department of Internal medicine, Geriatric Medicine section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway.
| | - Teemu Paajanen
- Work ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
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Vuoksimaa E, Saari TT, Aaltonen A, Aaltonen S, Herukka SK, Iso-Markku P, Kokkola T, Kyttälä A, Kärkkäinen S, Liedes H, Ollikainen M, Palviainen T, Ruotsalainen I, Toivola A, Urjansson M, Vasankari T, Vähä-Ypyä H, Forsberg MM, Hiltunen M, Jalanko A, Kälviäinen R, Kuopio T, Lähteenmäki J, Nyberg P, Männikkö M, Serpi R, Siltanen S, Palotie A, Kaprio J, Runz H, Julkunen V. TWINGEN - protocol for an observational clinical biobank recall and biomarker study to identify individuals with high risk of Alzheimer's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.03.23298018. [PMID: 37965200 PMCID: PMC10635260 DOI: 10.1101/2023.11.03.23298018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Introduction A better understanding of the earliest stages of Alzheimer's disease (AD) could expedite the development or administration of treatments. Large population biobanks hold the promise to identify individuals at an elevated risk of AD and related dementias based on health registry information. Here, we establish the protocol for an observational clinical recall and biomarker study called TWINGEN with the aim to identify individuals at high risk of AD by assessing cognition, health and AD-related biomarkers. Suitable candidates were identified and invited to participate in the new study among Finnish biobank donors according to TWINGEN study criteria. Methods and analysis A multi-center study (n=800) to obtain blood-based biomarkers, telephone-administered and web-based memory and cognitive parameters, questionnaire information on lifestyle, health and psychological factors, and accelerometer data for measures of physical activity, sedentary behavior and sleep. A sub-cohort are being asked to participate in an in-person neuropsychological assessment (n=200) and wear an Oura ring (n=50). All participants in the TWINGEN study have genome-wide genotyping data and up to 48 years of follow-up data from the population-based older Finnish Twin Cohort (FTC) study of the University of Helsinki. TWINGEN data will be transferred to Finnish Institute of Health and Welfare (THL) biobank and we aim to further to transfer it to the FinnGen study where it will be combined with health registry data for prediction of AD. Ethics and dissemination This recall study consists of FTC/THL/FinnGen participants whose data were acquired in accordance with the Finnish Biobank Act. The recruitment protocols followed the biobank protocols approved by Finnish Medicines Agency. The TWINGEN study plan was approved by the Ethics Committee of Hospital District of Helsinki and Uusimaa (number 16831/2022). THL Biobank approved the research plan with the permission no: THLBB2022_83.
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Affiliation(s)
- Eero Vuoksimaa
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Toni T Saari
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Aino Aaltonen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Sanna-Kaisa Herukka
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Paula Iso-Markku
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tarja Kokkola
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aija Kyttälä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sari Kärkkäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Liedes
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd., Oulu, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Ilona Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd., Espoo, Finland
| | - Auli Toivola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mia Urjansson
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Markus M Forsberg
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland Ltd., Kuopio, Finland
| | - Mikko Hiltunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anu Jalanko
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Reetta Kälviäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Teijo Kuopio
- Central Finland Biobank, Central Finland Health Care District, Jyväskylä, Finland
| | | | - Pia Nyberg
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services county of North Ostrobothnia, Oulu, Finland
- Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Minna Männikkö
- Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raisa Serpi
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services county of North Ostrobothnia, Oulu, Finland
| | - Sanna Siltanen
- Finnish Clinical Biobank Tampere, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Heiko Runz
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Translational Sciences, Biogen, Cambridge, MA, USA
| | - Valtteri Julkunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
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van Gils AM, van de Beek M, van Unnik AAJM, Tolonen A, Handgraaf D, van Leeuwenstijn M, Lötjönen J, van der Flier WM, Lemstra A, Rhodius‐Meester HFM. Optimizing cCOG, a Web-based tool, to detect dementia with Lewy Bodies. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12379. [PMID: 36569383 PMCID: PMC9773307 DOI: 10.1002/dad2.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022]
Abstract
Introduction Distinguishing dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) is challenging due to overlapping presentations. We adapted a Web-based test tool, cCOG, by adding a visuospatial task and a brief clinical survey and assessed its ability to differentiate between DLB and AD. Methods We included 110 patients (n = 30 DLB, n = 32 AD dementia, and n = 48 controls with subjective cognitive decline (SCD)). Full cCOG comprises six cognitive subtasks and a survey addressing self-reported DLB core and autonomic features. First, we compared cCOG cognitive tasks to traditional neuropsychological tasks for all diagnostic groups and clinical questions to validated assessments of clinical features in DLB only. Then, we studied the performance of cCOG cognitive tasks and clinical questions, separately and combined, in differentiating diagnostic groups. Results cCOG cognitive tasks and clinical survey had moderate to strong correlations to standard neuropsychological testing (.61≤ r s ≤ .77) and to validated assessments of clinical features (.41≤ r s ≤ .65), except for fluctuations and REM-sleep behavior disorder (RBD) (r s = .32 and r s = .10). Full cCOG, including both cognitive tasks and brief survey had a diagnostic accuracy (acc) of 0.82 [95% CI 0.73-0.89], with good discrimination of DLB versus AD (acc 0.87 [0.76-0.95]) and DLB versus controls (acc 0.94 [0.86-0.98]). Conclusion We illustrated that cCOG aids in distinguishing DLB and AD patients by using remote assessment of cognition and clinical features. Our findings pave the way to a funneled, harmonized diagnostic process among memory clinics and, eventually, a more timely and accurate diagnosis of DLB and AD.
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Affiliation(s)
- Aniek M. van Gils
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Marleen van de Beek
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Annemartijn A. J. M. van Unnik
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | | | - Dédé Handgraaf
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Mardou van Leeuwenstijn
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | | | - Wiesje M. van der Flier
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands,Department of Epidemiology and Data SciencesVrije Universiteit AmsterdamAmsterdam UMCAmsterdamThe Netherlands
| | - Afina Lemstra
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Hanneke F. M. Rhodius‐Meester
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamThe Netherlands,Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands,Department of Internal MedicineGeriatric Medicine SectionVrije Universiteit AmsterdamAmsterdam UMCAmsterdamThe Netherlands
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van Gils AM, Visser LN, Hendriksen HM, Georges J, Muller M, Bouwman FH, van der Flier WM, Rhodius-Meester HF. Assessing the Views of Professionals, Patients, and Care Partners Concerning the Use of Computer Tools in Memory Clinics: International Survey Study. JMIR Form Res 2021; 5:e31053. [PMID: 34870612 PMCID: PMC8686488 DOI: 10.2196/31053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/07/2021] [Accepted: 09/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background Computer tools based on artificial intelligence could aid clinicians in memory clinics in several ways, such as by supporting diagnostic decision-making, web-based cognitive testing, and the communication of diagnosis and prognosis. Objective This study aims to identify the preferences as well as the main barriers and facilitators related to using computer tools in memory clinics for all end users, that is, clinicians, patients, and care partners. Methods Between July and October 2020, we sent out invitations to a web-based survey to clinicians using the European Alzheimer’s Disease Centers network and the Dutch Memory Clinic network, and 109 clinicians participated (mean age 45 years, SD 10; 53/109, 48.6% female). A second survey was created for patients and care partners. They were invited via Alzheimer Europe, Alzheimer’s Society United Kingdom, Amsterdam Dementia Cohort, and Amsterdam Aging Cohort. A total of 50 patients with subjective cognitive decline, mild cognitive impairment, or dementia (mean age 73 years, SD 8; 17/34, 34% female) and 46 care partners (mean age 65 years, SD 12; 25/54, 54% female) participated in this survey. Results Most clinicians reported a willingness to use diagnostic (88/109, 80.7%) and prognostic (83/109, 76.1%) computer tools. User-friendliness (71/109, 65.1%); Likert scale mean 4.5, SD 0.7), and increasing diagnostic accuracy (76/109, 69.7%; mean 4.3, SD 0.7) were reported as the main factors stimulating the adoption of a tool. Tools should also save time and provide clear information on reliability and validity. Inadequate integration with electronic patient records (46/109, 42.2%; mean 3.8, SD 1.0) and fear of losing important clinical information (48/109, 44%; mean 3.7, SD 1.2) were most frequently indicated as barriers. Patients and care partners were equally positive about the use of computer tools by clinicians, both for diagnosis (69/96, 72%) and prognosis (73/96, 76%). In addition, most of them thought favorably regarding the possibility of using the tools themselves. Conclusions This study showed that computer tools in memory clinics are positively valued by most end users. For further development and implementation, it is essential to overcome the technical and practical barriers of a tool while paying utmost attention to its reliability and validity.
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Affiliation(s)
- Aniek M van Gils
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | - Leonie Nc Visser
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands.,Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Heleen Ma Hendriksen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | - Majon Muller
- Department of Internal Medicine, Geriatric Medicine Section, Amsterdam Cardiovascular Sciences Institute, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | - Femke H Bouwman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands.,Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | - Hanneke Fm Rhodius-Meester
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands.,Department of Internal Medicine, Geriatric Medicine Section, Amsterdam Cardiovascular Sciences Institute, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
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Vannucci M, Chiorri C, Favilli L. Web-Based Assessment of the Phenomenology of Autobiographical Memories in Young and Older Adults. Brain Sci 2021; 11:brainsci11050660. [PMID: 34070141 PMCID: PMC8158337 DOI: 10.3390/brainsci11050660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 01/10/2023] Open
Abstract
Autobiographical memories (ABMs) produce rich phenomenological experiences. Although few standardized and comprehensive measures of the phenomenology of ABMs have been developed, a web-based assessment of the full range of phenomenological properties is still missing. In the present study, we aimed to fill this gap and tested the psychometric properties of a web-based version of the Assessment of the Phenomenology of Autobiographical Memory (APAM) in a group of young and older adults. Specifically, taking advantage of the flexibility of web-based assessment methodology, we tested the rating consistency of APAM items, asking participants to rate the phenomenology of their ABMs with respect to seven cues, administered in one per day in seven different days. In each session, we also collected ratings of mood and arousal. Using linear mixed modeling (LMM), we could examine whether the phenomenology ratings differed with respect to age group while controlling for sex, age of the memory, arousal, mood, and specificity of the memory. Results revealed an adequate level of consistency of ratings in both young and older adults. Moreover, LMMs revealed a more intense experience of recollection and reliving (i.e., sensory and emotional) and a higher confidence in memory accuracy in older compared to younger adults. The theoretical and practical usefulness of a web-based assessment of the phenomenology of ABMs are discussed.
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Affiliation(s)
- Manila Vannucci
- Department of Neurofarba, Section of Psychology, University of Florence, 50135 Firenze, Italy;
- Correspondence: ; Tel.: +39-055-2055863; Fax: +39-055-6236047
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, 16126 Genova, Italy;
| | - Laura Favilli
- Department of Neurofarba, Section of Psychology, University of Florence, 50135 Firenze, Italy;
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