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Grazia A, Altomare D, Preis L, Monsch AU, Cappa SF, Gauthier S, Frölich L, Winblad B, Welsh-Bohmer KA, Teipel SJ, Boccardi M. Feasibility of a standard cognitive assessment in European academic memory clinics. Alzheimers Dement 2023; 19:2276-2286. [PMID: 36453876 DOI: 10.1002/alz.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022]
Abstract
INTRODUCTION Standardized cognitive assessment would enhance diagnostic reliability across memory clinics. An expert consensus adapted the Uniform Dataset (UDS)-3 for European centers, the clinician's UDS (cUDS). This study assessed its implementation acceptability and feasibility. METHODS We developed a survey investigating barriers, facilitators, and willingness to implement the cUDS. With a mixed-methods design, we analyzed data from academic memory clinics. RESULTS Seventy-eight percent of responding clinicians were experienced neuropsychologists/psychologists and 22% were medical specialists coming from 18 European countries. Sixty-five percent clinicians were willing to implement cUDS. General barriers related to implementation (43%) and clinical-methodological domains (21%). Favorable clinicians reported finances (15%) and digitalization (9%) as facilitating, but unavailability of local norms (23%) as hindering. Unfavorable clinicians reported logistical (23%) and time issues (18%). DISCUSSION Despite challenges, data showed moderate clinicians' acceptability and requirements to improve feasibility. Nonetheless, these results come from academic clinicians. The next steps will require feasibility evaluation in non-academic contexts.
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Affiliation(s)
- Alice Grazia
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock-Greifswald Standort, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock Universitätsmedizin, Rostock, Germany
| | - Daniele Altomare
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Lukas Preis
- Charité - Universitätsmedizin Berlin Campus Benjamin Franklin Klinik für Psychiatrie und Psychotherapie, Berlin, Germany
| | - Andreas U Monsch
- Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland, Basel, Switzerland
| | - Stefano F Cappa
- University Institute for Advanced Studies (IUSS), Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Serge Gauthier
- Mcgill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Canada
| | - Lutz Frölich
- Dpt. of Gerontopsychiatry, Medical Faculty Mannheim, University of Heidelberg, Germany, Central Institute of Mental Health (ZI), Mannheim, Germany
| | - Bengt Winblad
- Karolinska Institutet, Department NVS, Division of Neurogeriatrics, Solna, Sweden & Karolinska University Hospital, Theme Inflammation and Aging, Huddinge, Sweden
| | | | - Stefan J Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock-Greifswald Standort, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock Universitätsmedizin, Rostock, Germany
| | - Marina Boccardi
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock-Greifswald Standort, Rostock, Germany
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Boccardi M, Handels R, Gold M, Grazia A, Lutz MW, Martin M, Nosheny R, Robillard JM, Weidner W, Alexandersson J, Thyrian JR, Winblad B, Barbarino P, Khachaturian AS, Teipel S. Clinical research in dementia: A perspective on implementing innovation. Alzheimers Dement 2022; 18:2352-2367. [PMID: 35325508 DOI: 10.1002/alz.12622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 01/31/2023]
Abstract
The increasing global prevalence of dementia demands concrete actions that are aimed strategically at optimizing processes that drive clinical innovation. The first step in this direction requires outlining hurdles in the transition from research to practice. The different parties needed to support translational processes have communication mismatches; methodological gaps hamper evidence-based decision-making; and data are insufficient to provide reliable estimates of long-term health benefits and costs in decisional models. Pilot projects are tackling some of these gaps, but appropriate methods often still need to be devised or adapted to the dementia field. A consistent implementation perspective along the whole translational continuum, explicitly defined and shared among the relevant stakeholders, should overcome the "research-versus-adoption" dichotomy, and tackle the implementation cliff early on. Concrete next steps may consist of providing tools that support the effective participation of heterogeneous stakeholders and agreeing on a definition of clinical significance that facilitates the selection of proper outcome measures.
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Affiliation(s)
- Marina Boccardi
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald Standort, Rostock, Germany
| | - Ron Handels
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Division of Neurogeriatrics, Dept for Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | | | - Alice Grazia
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald Standort, Rostock, Germany.,Department of Psychosomatic Medicine, Rostock Universitätsmedizin, Rostock, Germany
| | - Michael W Lutz
- Department of Neurology Duke University School of Medicine, Durham, North Carolina, USA
| | - Mike Martin
- Gerontology Center, University of Zurich, Zürich, Switzerland
| | - Rachel Nosheny
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA.,San Francisco Veteran's Administration Medical Center, San Francisco, California, USA
| | - Julie M Robillard
- The University of British Columbia; BC Children's & Women's Hospitals, Vancouver, Canada
| | | | | | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald Standort, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Healthcare, University Medicine of Greifswald, Greifswald, Germany
| | - Bengt Winblad
- Division of Neurogeriatrics, Dept for Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | | | - Ara S Khachaturian
- Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Rockville, Maryland, USA.,Campaign to Prevent Alzheimer's Disease, Rockville, Maryland, USA
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald Standort, Rostock, Germany.,Department of Psychosomatic Medicine, Rostock Universitätsmedizin, Rostock, Germany
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Boccardi M, Monsch AU, Ferrari C, Altomare D, Berres M, Bos I, Buchmann A, Cerami C, Didic M, Festari C, Nicolosi V, Sacco L, Aerts L, Albanese E, Annoni JM, Ballhausen N, Chicherio C, Démonet JF, Descloux V, Diener S, Ferreira D, Georges J, Gietl A, Girtler N, Kilimann I, Klöppel S, Kustyniuk N, Mecocci P, Mella N, Pigliautile M, Seeher K, Shirk SD, Toraldo A, Brioschi-Guevara A, Chan KCG, Crane PK, Dodich A, Grazia A, Kochan NA, de Oliveira FF, Nobili F, Kukull W, Peters O, Ramakers I, Sachdev PS, Teipel S, Visser PJ, Wagner M, Weintraub S, Westman E, Froelich L, Brodaty H, Dubois B, Cappa SF, Salmon D, Winblad B, Frisoni GB, Kliegel M. Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe. Alzheimers Dement 2022; 18:29-42. [PMID: 33984176 PMCID: PMC9642857 DOI: 10.1002/alz.12365] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/11/2021] [Accepted: 04/05/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. METHODS To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. RESULTS With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. DISCUSSION This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond.
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Affiliation(s)
- Marina Boccardi
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
| | - Andreas U Monsch
- Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Daniele Altomare
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Chiara Cerami
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Mira Didic
- APHM, Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France
- Aix-Marseille Université, Inserm, INS, UMR_S 1106, 13005, Marseille, France
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Nicolosi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Leonardo Sacco
- Clinic of Neurology, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Liesbeth Aerts
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Jean-Marie Annoni
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Nicola Ballhausen
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - Jean-François Démonet
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Virginie Descloux
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Suzie Diener
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Nicola Girtler
- Clinical Psychology and Psychotherapy, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Ingo Kilimann
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Stefan Klöppel
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Nicole Kustyniuk
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Nathalie Mella
- Cognitive Aging Lab, University of Geneva, Geneva, Switzerland
| | - Martina Pigliautile
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Katrin Seeher
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Steven D Shirk
- VISN 1 New England MIRECC and VISN 1 New England GRECC, Bedford VA Healthcare System, Bedford, Department of Psychiatry and Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - Alessio Toraldo
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy, Milan Center for Neuroscience, Milan, Italy
| | - Andrea Brioschi-Guevara
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Kwun C G Chan
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Alessandra Dodich
- Neuroimaging and Innovative Molecular Tracers Laboratory, and Division of Nuclear Medicine, Diagnostic Departement, University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Alice Grazia
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Walter Kukull
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Germany, ZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Inez Ramakers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Stefan Teipel
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Michael Wagner
- DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lutz Froelich
- University of Heidelberg, Heidelberg, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Bruno Dubois
- Hôpital Pitié-Salpêtrière, AP-HP, Alzheimer Research Institute (IM2A), and Institut du cerveau et la moelle (ICM), Sorbonne Université, Paris, France
| | - Stefano F Cappa
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - David Salmon
- Department of Neurosciences, University of California San Diego School of Medicine, San Diego, USA
| | - Bengt Winblad
- Dept NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Matthias Kliegel
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland
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