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Postema MC, Dubbelman MA, Claesen J, Ritchie C, Verrijp M, Visser L, Visser PJ, Zwan MD, van der Flier WM, Sikkes SAM. Facilitating clinical use of the Amsterdam Instrumental Activities of Daily Living Questionnaire: Normative data and a diagnostic cutoff value. J Int Neuropsychol Soc 2024:1-6. [PMID: 38456286 DOI: 10.1017/s1355617724000031] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q) is well validated and commonly used to assess difficulties in everyday functioning regarding dementia. To facilitate interpretation and clinical implementation across different European countries, we aim to provide normative data and a diagnostic cutoff for dementia. METHODS Cross-sectional data from Dutch Brain Research Registry (N = 1,064; mean (M) age = 62 ± 11 year; 69.5% female), European Medial Information Framework-Alzheimer's Disease 90 + (N = 63; Mage = 92 ± 2 year; 52.4% female), and European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (N = 247; Mage = 63 ± 7 year; 72.1% female) were used. The generalized additive models for location, scale, and shape framework were used to obtain normative values (Z-scores). The beta distribution was applied, and combinations of age, sex, and educational attainment were modeled. The optimal cutoff for dementia was calculated using area under receiver operating curves (AUC-ROC) and Youden Index, using data from Amsterdam Dementia Cohort (N = 2,511, Mage = 64 ± 8 year, 44.4% female). RESULTS The best normative model accounted for a cubic-like decrease of IADL performance with age that was more pronounced in low compared to medium/high educational attainment. The cutoff for dementia was 1.85 standard deviation below the population mean (AUC = 0.97; 95% CI [0.97-0.98]). CONCLUSION We provide regression-based norms for A-IADL-Q and a diagnostic cutoff for dementia, which help improve clinical assessment of IADL performance across European countries.
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Affiliation(s)
- Merel C Postema
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Mark A Dubbelman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Center for Alzheimer Research and Treatment, Harvard Medical School, Boston, MA, USA
| | - Jürgen Claesen
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Craig Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | - Leonie Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Pieter-Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Waterink L, Masselink LA, van der Lee SJ, Visser LNC, Cleutjens S, van der Schaar J, van Harten AC, Scheltens P, Sikkes SAM, van der Flier WM, Zwan MD. Interest in genetic susceptibility testing and disclosure of AD dementia risk in cognitively normal adults: a survey study. Alzheimers Res Ther 2024; 16:1. [PMID: 38167083 PMCID: PMC10759504 DOI: 10.1186/s13195-023-01364-w] [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: 06/20/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Apolipoprotein-E (APOE) genetic testing for Alzheimer's disease is becoming more important as clinical trials are increasingly targeting individuals carrying APOE-ε4 alleles. Little is known about the interest in finding out one's genetic risk for Alzheimer's disease in the general population. Our objective was to examine this in a sample of cognitively normal (CN) adults within a population-based online research registry with the goal to implement APOE-ε4 status for trial recruitment. METHODS An online survey was completed by 442 CN participants between the age of 49 and 75 years (56% female) from the Dutch Brain Research Registry. The survey assessed interest in participation in research into, and disclosure of, genetic risk for dementia. The survey assessed interest in participation in research into, and disclosure of, genetic risk for dementia and knowing their genetic risk in different hypothetical risk scenarios (10%, 30%, and 50% genetic risk for dementia at age 85, corresponding to APOEε2/ε2 or ε2/ε3, APOEε3/ε4 or ε2ε4, and APOE-ε4/ε4 genotypes). Cochran's Q and post hoc McNemar tests were used to analyse differences in frequencies across scenarios. RESULTS Most participants were interested in participating in research into and disclosure of their genetic risk (81%). The most reported reason was to contribute to scientific research (94%). Interest was higher in males, whilst lower-educated participants were more often undecided. When provided with different risk scenarios, interest in knowing their risk was somewhat higher in the scenarios with higher risk, i.e. in the 50% (79%) compared to the 10% scenario (73%;χ2(2) = 7.98; p = .005). Most individuals expected they would share their genetic risk with close relatives (77-89%), would participate in medication trials (79-88%), and would make long-term arrangements, e.g. retirement, health care, will (69-82%), with larger proportions for scenarios with higher hypothetical genetic risk. CONCLUSIONS Our findings indicate that the vast majority of CN adults participating in a research registry expresses interest in AD genetic risk research and disclosure. Interest in genetic risk disclosure is higher in scenarios corresponding to the APOE-ε4 genotype. This suggests APOE-ε4 screening within an online research registry is potentially a well-received method to accelerate inclusion for trials.
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Affiliation(s)
- Lisa Waterink
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands.
| | - Larissa A Masselink
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
| | - Sven J van der Lee
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Leonie N C Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Medical Psychology, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, 1105, AZ, the Netherlands
- Amsterdam Public Health research Institute, Quality of Care, Amsterdam, 1105, BP, The Netherlands
| | - Solange Cleutjens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
| | - Jetske van der Schaar
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands
| | - Argonde C van Harten
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- EQT Life Sciences Partners, Amsterdam, 1071, DV, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, 1081, HV, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, 1081, HZ, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081, HV, The Netherlands
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3
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Bakker ED, van Maurik IS, Zwan MD, Gillissen F, van der Veere PJ, Bouwman FH, Pijnenburg YAL, van der Flier WM. Impact of COVID-19 pandemic on mortality rate in memory clinic patients. Alzheimers Dement (Amst) 2024; 16:e12541. [PMID: 38288266 PMCID: PMC10823153 DOI: 10.1002/dad2.12541] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024]
Abstract
INTRODUCTION We investigated whether mortality in memory clinic patients changed due to coronavirus disease 2019 (COVID-19) pandemic. METHODS We included patients from the Amsterdam Dementia Cohort: (1) n = 923 pandemic patients (baseline visit: 2017-2018, follow-up: until 2021), and (2) n = 830 historical control patients (baseline visit: 2015-2016, follow-up: until 2019). Groups were well-balanced. We compared mortality during pandemic with historical control patients using Cox regression. Differences in cause of death between groups were explored using Fisher's exact test. RESULTS Pandemic patients had a higher risk of mortality than historical control patients (hazard ratio [HR] [95% confidence interval {CI}] = 1.34 [1.05-1.70]). Stratified for syndrome diagnosis, the effect remained significant in dementia patients (HR [95% CI] = 1.35 [1.03-1.78]). Excluding patients who died of COVID-19-infection, the higher mortality risk in pandemic patients attenuated (HR [95% CI] = 1.24 [0.97-1.58]). Only the difference in cause of death between pandemic patients and historical control patients for death to COVID-19-infection (p = 0.001) was observed. CONCLUSION Memory clinic patients had increased mortality risk during COVID-19 compared to historical control patients, attributable to dementia patients. Highlights We investigated if mortality rates in memory clinic patients changed due to COVID-19 pandemic.We included patients along the cognitive continuum, including SCD, MCI, and dementia.We used a well-balanced historical control group.Memory clinic patients had higher risk for mortality during COVID-19 lockdown.Our results indicate that excess mortality is mainly caused by death to COVID-19 infection.
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Affiliation(s)
- Els D. Bakker
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Ingrid S. van Maurik
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
- Amsterdam UMC location Vrije Universiteit AmsterdamEpidemiology and Data ScienceAmsterdamThe Netherlands
- Amsterdam Public HealthMethodologyAmsterdamThe Netherlands
- Northwest AcademyNorthwest Clinics AlkmaarAlkmaarThe Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Freek Gillissen
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Pieter J. van der Veere
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
- Amsterdam UMC location Vrije Universiteit AmsterdamEpidemiology and Data ScienceAmsterdamThe Netherlands
- Amsterdam Public HealthMethodologyAmsterdamThe Netherlands
| | - Femke H. Bouwman
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, NeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VUmcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamThe Netherlands
- Amsterdam UMC location Vrije Universiteit AmsterdamEpidemiology and Data ScienceAmsterdamThe Netherlands
- Amsterdam Public HealthMethodologyAmsterdamThe Netherlands
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van Maurik IS, Bakker ED, van Unnik AAJM, Broulikova HM, Zwan MD, van de Giessen E, Berkhof J, Bouwman FH, Bosmans JE, van der Flier WM. How healthy participants value additional diagnostic testing with amyloid-PET in patients diagnosed with mild cognitive impairment - a bidding game experiment. Alzheimers Res Ther 2023; 15:208. [PMID: 38017549 PMCID: PMC10683285 DOI: 10.1186/s13195-023-01346-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND To estimate the perceived value of additional testing with amyloid-PET in Euros in healthy participants acting as analogue patients with mild cognitive impairment (MCI). METHODS One thousand four hundred thirty-one healthy participants acting as analogue MCI patients (mean age 65 ± 8, 929 (75%) female) were recruited via the Dutch Brain Research Registry. Participants were asked to identify with a presented case (video vignette) of an MCI patient and asked whether they would prefer additional diagnostic testing with amyloid PET in this situation. If yes, respondents were asked how much they would be willing to pay for additional diagnostic testing. Monetary value was elicited via a bidding game in which participants were randomized over three conditions: (A) additional testing results in better patient management, (B) Same as condition A and a delay in institutionalization of 3 months, and (C) same as A and a delay in institutionalization of 6 months. Participants who were not willing to take a test were compared with participants who were willing to take a test using logit models. The highest monetary value per condition was analyzed using random-parameter mixed models. RESULTS The vast majority of participants acting as analogue MCI patients (87% (n = 1238)) preferred additional testing with amyloid PET. Participants who were not interested were more often female (OR = 1.61 95% CI [1.09-2.40]) and expressed fewer worries to get AD (OR = 0.64 [0.47-0.87]). The median "a priori" (i.e., before randomization) monetary value of additional diagnostic testing was €1500 (IQR 500-1500). If an additional amyloid PET resulted in better patient management (not further specified; condition A), participants were willing to pay a median price of €2000 (IQR = 1000-3500). Participants were willing to pay significantly more than condition A (better patient management) if amyloid-PET testing additionally resulted in a delay in institutionalization of 3 months (€530 [255-805] on top of €2000, condition B) or 6 months (€596 [187-1005] on top of €2000, condition C). CONCLUSIONS Members of the general population acting as MCI patients are willing to pay a substantial amount of money for amyloid-PET and this increases when diagnostic testing leads to better patient management and the prospect to live longer at home.
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Affiliation(s)
- I S van Maurik
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands.
| | - E D Bakker
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - A A J M van Unnik
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - H M Broulikova
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M D Zwan
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - E van de Giessen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, the Netherlands
| | - J Berkhof
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - F H Bouwman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - J E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - W M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
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Neal DP, Ettema TP, Zwan MD, Dijkstra K, Finnema E, Graff M, Muller M, Dröes RM. FindMyApps compared with usual tablet use to promote social health of community-dwelling people with mild dementia and their informal caregivers: a randomised controlled trial. EClinicalMedicine 2023; 63:102169. [PMID: 37680943 PMCID: PMC10480525 DOI: 10.1016/j.eclinm.2023.102169] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023] Open
Abstract
Background FindMyApps is a tablet-based eHealth intervention designed to help people learn to use a tablet and find easy-to-use apps. This study evaluated the effectiveness of FindMyApps for supporting social health of people living with dementia, and sense of competence of their informal caregivers. Methods A single-centre, two-arm, non-blinded randomised controlled trial was conducted (Netherlands Trial Register NL8157). From 1st January 2020 to 31st July 2022, community-dwelling people in the Netherlands with a pre-established diagnosis of mild cognitive impairment (MCI) or dementia (Brief Cognitive Rating Scale 17-32), an informal caregiver and internet connection were allocated by block randomisation to receive FindMyApps or digital care-as-usual. Primary outcomes (measured at baseline and after three months) for people with dementia/MCI were self-management (Adult Social Care Outcomes Toolkit total score) and social participation (Maastricht Social Participation Profile frequency and diversity scores), and for caregivers, sense of competence (Short Sense of Competence Questionnaire total score). Between-group differences were tested by MANCOVA or ANCOVA (alpha = 0.05). Findings 150 dyads were randomised (FindMyApps n = 76, care-as-usual n = 74). Follow-up data were available for 128 dyads (FindMyApps n = 64, care-as-usual n = 64), who were included in the analysis in the trial arm to which they were assigned. No harms of the intervention were identified. There were no statistically significant differences in outcomes for people with dementia/MCI at group level. Diagnosis and experiencing apathy appeared to be relevant effect modifiers of secondary outcomes (neuropsychiatric symptoms, positive affect, sense of belonging, and pleasurable activities). Caregivers who received FindMyApps had higher sense of competence at three months (F [1,123] = 7.01, p = 0.0092, η2 = 0.054). Interpretation Overall we found no evidence that the FindMyApps intervention better supported social participation or self-management of people with MCI/dementia than digital care-as-usual. FindMyApps does seem to better support informal caregivers' sense of competence. For people with a diagnosis of mild dementia and older people, better tailored interventions, implementation and outcome measures may be needed. Funding Marie Skłodowska Curie Actions Innovative Training Network H2020 MSCA ITN, grant agreement number 813196.
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Affiliation(s)
- David P. Neal
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Mental Health Program, Amsterdam, the Netherlands
| | - Teake P. Ettema
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Mental Health Program, Amsterdam, the Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Karin Dijkstra
- Saxion University of Applied Sciences, School of Health, Research Group Smart Health, Handelskade 75, 7417 DH, Deventer, the Netherlands
| | - Evelyn Finnema
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900 CB, Leeuwarden, the Netherlands
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Maud Graff
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA, Nijmegen, the Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, 6525 GA, Nijmegen, the Netherlands
| | - Majon Muller
- Department of Internal Medicine, Geriatrics Section, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Mental Health Program, Amsterdam, the Netherlands
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6
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Bakker ED, van der Pas SL, Zwan MD, Gillissen F, Bouwman FH, Scheltens P, van der Flier WM, van Maurik IS. Steeper memory decline after COVID-19 lockdown measures. Alzheimers Res Ther 2023; 15:81. [PMID: 37061745 PMCID: PMC10104769 DOI: 10.1186/s13195-023-01226-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/05/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND During COVID-19 lockdown measures, memory clinic patients reported worries for faster cognitive decline, due to loss of structure and feelings of loneliness and depression. We aimed to investigate the impact of the COVID-19 lockdown on rate of cognitive decline in a mixed memory clinic population, compared to matched historical controls. METHODS We included patients who visited Alzheimer Center Amsterdam 6 months to 1 week before the first Dutch COVID-19 lockdown, and had a second visit 1 year later, after this lockdown period (n = 113; 66 ± 7 years old; 30% female; n = 55 dementia, n = 31 mild cognitive impairment (MCI), n = 18 subjective cognitive decline (SCD), n = 9 postponed diagnosis). Historical controls (visit in 2016/2017 and second visit 1 year later (n = 640)) were matched 1:1 to lockdown patients by optimal Mahalanobis distance matching (both groups n = 113). Groups were well matched. Differences between lockdown patients and historical controls over time in Mini-Mental State Examination, Trail Making Test part A and B, Rey-Auditory Verbal Learning Test (RAVLT) immediate and delayed recall, and category fluency scores were analyzed using linear mixed effect models with random intercepts. We examined differences in rate of cognitive decline between whole groups, and after stratification in SCD, MCI, and dementia separately. RESULTS Lockdown patients had a faster rate of memory decline compared to controls on both RAVLT immediate [B(SE) = - 2.62 (1.07), p = 0.015] and delayed recall [B(SE) = - 1.07 (0.34), p = 0.002]. Stratification by syndrome diagnosis showed that this effect was largely attributable to non-demented participants, as we observed faster memory decline during lockdown in SCD and MCI (RAVLT immediate [SCD: B(SE) = - 6.85 (2.97), p = 0.027; MCI: B(SE) = - 6.14 (1.78), p = 0.001] and delayed recall [SCD: B(SE) = - 2.45 (1.11), p = 0.035; MCI: B(SE) = - 1.50 (0.51), p = 0.005]), but not in dementia. CONCLUSION Memory clinic patients, specifically in pre-dementia stages, showed faster memory decline during COVID-19 lockdown, providing evidence that lockdown regulations had a deleterious effect on brain health. In individuals that may have been able to deal with accumulating, subclinical neuropathology under normal and structured circumstances, the additional stress of lockdown regulations may have acted as a "second hit," resulting in less beneficial disease trajectory.
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Affiliation(s)
- Els D Bakker
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
| | - Stéphanie L van der Pas
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Freek Gillissen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Ingrid S van Maurik
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, De Boelelaan 1118, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
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7
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Fruijtier AD, van der Schaar J, van Maurik IS, Zwan MD, Scheltens P, Bouwman F, Pijnenburg YAL, van Berckel BNM, Ebenau J, van der Flier WM, Smets EMA, Visser LNC. Identifying best practices for disclosure of amyloid imaging results: A randomized controlled trial. Alzheimers Dement 2023; 19:285-295. [PMID: 35366050 PMCID: PMC10084251 DOI: 10.1002/alz.12630] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 05/06/2021] [Revised: 12/22/2021] [Accepted: 01/25/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Empirical studies on effective communication for amyloid disclosure in mild cognitive impairment (MCI) are lacking. We aimed to study the impact of six communication strategies. METHOD We performed a randomized controlled trial with seven randomly assigned, video-vignette conditions: six emphasizing a communication strategy and one basic condition. All showed a scripted consultation of a neurologist disclosing positive amyloid positron emission tomography (PET) scan results to an MCI patient. Healthy individuals (N = 1017; mean age ± SD 64 ± 8, 808 (79%) female) were instructed to imagine themselves in the video, answered questionnaires assessing information recall, emotional state, and behavioral intentions, and evaluate the physician/information. RESULTS "Risk best practice" resulted in highest free recall compared to other strategies (P < .05), except "emotional support". Recall in "emotional support" was better compared to "basic-' and elaborate information"(P < .05). "Risk best practice" resulted in the highest uncertainty (P < .001). "Teach-back" and "emotional support" contributed to the highest evaluations (P -values < .01). CONCLUSION Risk communication best practices, attending to emotions, and teach-back techniques enhance information recall of amyloid-PET results, and could contribute to positive care evaluations.
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Affiliation(s)
- Agnetha D Fruijtier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Medical Psychology, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jetske van der Schaar
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ingrid S van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jarith Ebenau
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Leonie N C Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Solna, Sweden
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8
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Waterink L, Bakker ED, Visser LN, Mangialasche F, Kivipelto M, Deckers K, Köhler S, Sikkes SA, Prins ND, Scheltens P, van der Flier WM, Zwan MD. The impact of COVID‐19 restrictions after one year on modifiable risk factors related to brain health in older adults in The Netherlands. Alzheimers Dement 2022. [DOI: 10.1002/alz.062303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Lisa Waterink
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Els D. Bakker
- Alzheimer Center Amsterdam, Amsterdam UMC, VUmc, department of neurology Amsterdam Netherlands
| | - Leonie N.C. Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Stockholm Sweden
| | | | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Stockholm Sweden
| | - Kay Deckers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Maastricht Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Maastricht University Medical Center Maastricht Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Amsterdam Netherlands
| | - Niels D. Prins
- VU University Medical Center Amsterdam Netherlands
- Brain Research Center Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- LSP dementia Fund Amsterdam Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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9
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Wang J, Guo C, Meng Z, Zwan MD, Chen X, Seelow S, Lundström SL, Rodin S, Teunissen CE, Zubarev RA. Testing the link between isoaspartate and Alzheimer's disease etiology. Alzheimers Dement 2022; 19:1491-1502. [PMID: 35924765 DOI: 10.1002/alz.12735] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/09/2022]
Abstract
Isoaspartate (isoAsp) is a damaging amino acid residue formed in proteins as a result of spontaneous deamidation. IsoAsp disrupts protein structures, making them prone to aggregation. Here we strengthened the link between isoAsp and Alzheimer's disease (AD) by novel approaches to isoAsp analysis in human serum albumin (HSA), the most abundant blood protein and a major carrier of amyloid beta (Aβ) and phosphorylated tau (p-tau) in blood. We discovered a reduced amount of anti-isoAsp antibodies (P < 0.0001), an elevated isoAsp level in HSA (P < 0.001), more HSA aggregates (P < 0.0001), and increased levels of free Aβ (P < 0.01) in AD blood compared to controls. We also found that deamidation significantly reduces HSA capacity to bind with Aβ and p-tau (P < 0.05). These suggest the presence in AD of a bottleneck in clearance of Aβ and p-tau, leading to their increased concentrations in the brain and facilitating their aggregations there.
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Affiliation(s)
- Jijing Wang
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden
| | - Cong Guo
- Department of Physics and International Centre for Quantum and Molecular Structures, College of Sciences, Shanghai University, Shanghai, China
| | - Zhaowei Meng
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden
| | - Marissa D Zwan
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Xin Chen
- Department of Physics and International Centre for Quantum and Molecular Structures, College of Sciences, Shanghai University, Shanghai, China
| | - Sven Seelow
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden
| | - Susanna L Lundström
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden
| | - Sergey Rodin
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Roman A Zubarev
- Department of Medical Biophysics and Biochemistry, Karolinska Institutet, Stockholm, Sweden.,Endocrinology Research Centre, Moscow, Russian Federation.,Department of Pharmacological & Technological Chemistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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10
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Waterink L, Bakker ED, Visser LNC, Mangialasche F, Kivipelto M, Deckers K, Köhler S, Sikkes SAM, Prins ND, Scheltens P, van der Flier WM, Zwan MD. Changes in Brain-Health Related Modifiable Risk Factors in Older Adults After One Year of COVID-19-Restrictions. Front Psychiatry 2022; 13:877460. [PMID: 35722572 PMCID: PMC9201112 DOI: 10.3389/fpsyt.2022.877460] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has major influence on lifestyle and mental health, which might affect brain-health and increase the risk of cognitive decline, particularly in older adults. We aimed to describe changes in modifiable risk factors related to brain-health in older adults after one year of COVID-19 restrictions. Methods An online survey was disseminated between February and March 2021 to 17,773 registrants of the Dutch Brain Research Registry, aged ≥50, without a self-reported diagnosis of mild cognitive impairment or dementia. Participants were asked to report potential changes in behaviors during the COVID-19 pandemic, compared to pre-pandemic, in eight domains related to brain health: physical activity, sleep, feeling of memory decline, perceived stress, feeling of loneliness, diet, alcohol consumption, and smoking. We used negative binomial regression analyses to relate (socio)demographics, subjective memory complaints and COVID-19 related aspects (fear of, or current/past COVID-19 infection) to the number of reported detrimental and beneficial changes as dependent variable. Results 3,943 participants (66 ± 8 years old; 76% female; 71% highly educated) completed the survey. After one year of COVID-19-restrictions, 74% reported at least one detrimental lifestyle change unfavorable for their brain health, most frequently reported were feelings of loneliness, sleep problems, and less physical activity. 60% of participants reported at least one beneficial change, which were most often more physical activity, healthier dietary habits, and less alcohol consumption. Individuals who are younger [incidence rate ratio (IRR) = 0.99, 95% CI = 0.98-0.99], female (1.20, 1.11-1.30), living alone (1.20, 1.11-1.28) and in urban environments (1.18, 1.08-1.29), who are less satisfied with their income (1.38, 1.17-1.62), experiencing subjective memory complaints (1.40, 1.28-1.52) and those with a past or current (1.19, 1.06-1.34) or fear of a COVID-19 infection (1.33, 1.25-1.42) reported higher numbers of detrimental changes. Discussion The COVID-19 pandemic has influenced lifestyle in both positive and negative ways. We identified (socio)demographic factors associated with more detrimental changes in modifiable risk factors related to brain health, suggesting that some individuals are more vulnerable for the impact of the COVID-19 pandemic. These findings provide an opportunity for targeted prevention and education to promote a healthy lifestyle during and after the pandemic.
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Affiliation(s)
- Lisa Waterink
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Els D. Bakker
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Leonie N. C. Visser
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, Amsterdam, Netherlands
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Kay Deckers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sebastian Köhler
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Life Sciences Partners Dementia Fund, Amsterdam, Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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11
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Bakker ED, van Maurik IS, Mank A, Zwan MD, Waterink L, van den Buuse S, van den Broeke JR, Gillissen F, van de Beek M, Lemstra E, van den Bosch KA, van Leeuwenstijn M, Bouwman FH, Scheltens P, van der Flier WM. Psychosocial Effects of COVID-19 Measures on (Pre-)Dementia Patients During Second Lockdown. J Alzheimers Dis 2022; 86:931-939. [PMID: 35034903 DOI: 10.3233/jad-215342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The COVID-19 pandemic poses enormous social challenges, especially during lockdown. People with cognitive decline and their caregivers are particularly at risk of lockdown consequences. OBJECTIVE To investigate psychosocial effects in (pre-)dementia patients and caregivers during second lockdown and compare effects between first and second lockdown. METHODS We included n = 511 (pre-)dementia patients and n = 826 caregivers from the Amsterdam Dementia Cohort and via Alzheimer Nederland. All respondents completed a self-designed survey on psychosocial effects of COVID-19. We examined relations between experienced support and psychosocial and behavioral symptoms using logistic regression. In a subset of patients and caregivers we compared responses between first and second lockdown using generalized estimating equation. RESULTS The majority of patients (≥58%) and caregivers (≥60%) reported that family and friends, hobbies, and music helped them cope. Support from family and friends was strongly related to less negative feelings in patients (loneliness: OR = 0.3[0.1-0.6]) and caregivers (loneliness: OR = 0.2[0.1-0.3]; depression: OR = 0.4[0.2-0.5]; anxiety: OR = 0.4[0.3-0.6]; uncertainty: OR = 0.3[0.2-0.5]; fatigue: OR = 0.3[0.2-0.4]; stress: OR = 0.3[0.2-0.5]). In second lockdown, less psychosocial and behavioral symptoms were reported compared to first lockdown (patients; e.g., anxiety: 22% versus 13%, p = 0.007; apathy: 27% versus 8%, p < 0.001, caregivers; e.g., anxiety: 23% versus 16%, p = 0.033; patient's behavioral problems: 50% versus 35%, p < 0.001). Patients experienced more support (e.g., family and friends: 52% versus 93%, p < 0.001; neighbors: 28% versus 66%, p < 0.001). CONCLUSION During second lockdown, patients and caregivers adapted to challenges posed by lockdown, as psychosocial and behavioral effects decreased, while patients experienced more social support compared to first lockdown. Support from family and friends is a major protective factor for negative outcomes in patients and caregivers.
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Affiliation(s)
- Els D Bakker
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ingrid S van Maurik
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Arenda Mank
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marissa D Zwan
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lisa Waterink
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Freek Gillissen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marleen van de Beek
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Evelien Lemstra
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Karlijn A van den Bosch
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Mardou van Leeuwenstijn
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Femke H Bouwman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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12
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Verrijp M, Dubbelman MA, Visser LNC, Jutten RJ, Nijhuis EW, Zwan MD, van Hout HPJ, Scheltens P, van der Flier WM, Sikkes SAM. Everyday Functioning in a Community-Based Volunteer Population: Differences Between Participant- and Study Partner-Report. Front Aging Neurosci 2022; 13:761932. [PMID: 35069172 PMCID: PMC8767803 DOI: 10.3389/fnagi.2021.761932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Impaired awareness in dementia caused by Alzheimer's disease and related disorders made study partner-report the preferred method of measuring interference in "instrumental activities of daily living" (IADL). However, with a shifting focus toward earlier disease stages and prevention, the question arises whether self-report might be equally or even more appropriate. The aim of this study was to investigate how participant- and study partner-report IADL perform in a community-based volunteer population without dementia and which factors relate to differences between participant- and study partner-report. Methods: Participants (N = 3,288; 18-97 years, 70.4% females) and their study partners (N = 1,213; 18-88 years, 45.8% females) were recruited from the Dutch Brain Research Registry. IADL were measured using the Amsterdam IADL Questionnaire. The concordance between participant- and study partner-reported IADL difficulties was examined using intraclass correlation coefficient (ICC). Multinomial logistic regressions were used to investigate which demographic, cognitive, and psychosocial factors related to participant and study partner differences, by looking at the over- and underreport of IADL difficulties by the participant, relative to their study partner. Results: Most A-IADL-Q scores represented no difficulties for both participants (87.9%) and study partners (89.4%). The concordance between participants and study partners was moderate (ICC = 0.55, 95% confidence interval [CI] = [0.51, 0.59]); 24.5% (N = 297) of participants overreported their IADL difficulties compared with study partners, and 17.8% (N = 216) underreported difficulties. The presence of depressive symptoms (odds ratio [OR] = 1.31, 95% CI = [1.12, 1.54]), as well as memory complaints (OR = 2.45, 95% CI = [1.80, 3.34]), increased the odds of participants overreporting their IADL difficulties. Higher IADL ratings decreased the odds of participant underreport (OR = 0.71, 95% CI = [0.67, 0.74]). Conclusion: In this sample of community-based volunteers, most participants and study partners reported no major IADL difficulties. Differences between participant and study partner were, however, quite prevalent, with subjective factors indicative of increased report of IADL difficulties by the participant in particular. These findings suggest that self- and study partner-report measures may not be interchangeable, and that the level of awareness needs to be considered, even in cognitively healthy individuals.
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Affiliation(s)
- Merike Verrijp
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Leonie N. C. Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Elke W. Nijhuis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Hein P. J. van Hout
- Department of General Practice and Medicine for Older Persons, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology, Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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13
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Bakker ED, Van Maurik IS, Mank A, Zwan MD, van den Buuse S, van den Broeke JR, Gillissen F, van de Beek M, Lemstra E, van den Bosch KA, van Leeuwenstijn M, Bouwman FH, Scheltens P, van der Flier WM. Psychosocial effects of Corona virus measures on (pre‐)dementia patients during 2
nd
lockdown. Alzheimers Dement 2021. [PMCID: PMC9011621 DOI: 10.1002/alz.053995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background The COVID‐19 pandemic poses enormous social challenges, especially during lockdown. Recently, the second lockdown started in the Netherlands. We aimed to investigate and compare the psychosocial effects of corona measures during lockdown in memory clinic (pre‐)dementia patients and their caregivers. Method During second lockdown, n=137 symptomatic patients (age=67.7±6.54, 36.5%F, MMSE = 24.4±4.7; n=82 dementia, n=55 MCI), n=244 cognitively normal (age=63.6±7.56, 38.9%F, MMSE = 28.8±1.18; SCD) and n=198 caregivers of Alzheimer Center Amsterdam completed a survey on psychosocial effects of corona. Questions related to loneliness, worries for faster cognitive decline, psychological and behavioral problems. In a subset of patients (n=169) and caregivers (n=38) we were able to compare their answers to answers on a similar survey completed during first lockdown (May 2020). Result In total, n=17 (4.5%) patients [n=3 (2.2%) symptomatic, n=14 (5.7%) cognitively normal] and n=8 (4%) caregivers reported a positive test result for COVID‐19. Over one‐third of caregivers reported worries for faster cognitive decline [n=76 (38%)] and behavioral problems [n=70 (35%)] in patients. Feelings of loneliness were experienced by n=23 (17%) symptomatic patients, n=44 (18%) cognitively normal and n=50 (25%) caregivers. One quarter of patients [n=78 (25%)] reported more depressive feelings during lockdown [n=27 (20%) symptomatic, n=51 (21%) cognitively normal]. More feelings of fatigue were reported by n=23 (17%) symptomatic patients, n=46 (19%) cognitively normal, and n=67 (34%) caregivers. Comparing results to those obtained during the first lockdown, feelings of loneliness [Χ2=26.4, p<.001 in patients, Χ2=10.3, p<.001 in caregivers] and anxiety [Χ2=25.9, p<.001 in patients, Χ2=6.69, p=.010 in caregivers] increased. During second lockdown, less feelings of apathy [Χ2=13.0, p<.001], but more depressive feelings [Χ2=27.6, p<.001] were reported in patients compared to first lockdown. Caregivers were more worried for memory decline in patients during second lockdown [Χ2=4.09, p=.043]. Conclusion Compared to first lockdown, feelings of loneliness, anxiety, worries for faster cognitive decline and depressive feelings increased in second lockdown. A noticeable part of (pre‐)dementia patients and caregivers report feelings of loneliness, worries for faster cognitive decline, psychological and behavioral problems in second lockdown. These psychosocial effects are more frequently reported by caregivers than patients.
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Affiliation(s)
- Els D Bakker
- Alzheimer Center Amsterdam, Amsterdam UMC, VUmc, Department of Neurology Amsterdam Netherlands
| | - Ingrid S Van Maurik
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science Amsterdam Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Arenda Mank
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science Amsterdam Netherlands
- Alzheimer Center Amsterdam Amsterdam Netherlands
| | - Marissa D Zwan
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam Netherlands
| | | | | | - Freek Gillissen
- Alzheimer Center Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marleen van de Beek
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Evelien Lemstra
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Karlijn A van den Bosch
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Mardou van Leeuwenstijn
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center Amsterdam Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam Netherlands
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14
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Zwan MD, Deckers K, Claassen JA, Oosterman JM, de Heus RA, van de Rest O, de Groot LC, Smidt N, Broersen LM, Counotte D, Sikkes SA, van Boxtel MP, Aarts E, van der Flier WM, Koehler S. Study design of FINGER‐NL: A multidomain lifestyle intervention in Dutch older adults to prevent cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marissa D. Zwan
- Alzheimer Center & Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Jurgen A.H.R. Claassen
- Department of Geriatrics & Radboud UMC Alzheimer Center Radboud University Medical Center Nijmegen Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen Netherlands
| | - Rianne A.A. de Heus
- Department of Geriatrics & Radboud UMC Alzheimer Center Radboud University Medical Center Nijmegen Netherlands
| | - Ondine van de Rest
- Wageningen University Division of Human Nutrition Chair group Nutritional Biology Wageningen Netherlands
| | - Lisette C.P.G.M. de Groot
- Wageningen University Division of Human Nutrition Chair group Nutritional Biology Wageningen Netherlands
| | - Nynke Smidt
- Department of Epidemiology University of Groningen University Medical Center Groningen Groningen Netherlands
| | - Laus M. Broersen
- Danone Nutricia Research Specialized Nutrition Utrecht Netherlands
| | | | - Sietske A.M. Sikkes
- VU University Department of Clinical Neuro and Developmental Psychology Amsterdam Netherlands
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Martin P.J. van Boxtel
- Alzheimer Centrum Limburg Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Esther Aarts
- Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center & Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam Netherlands
| | - Sebastian Koehler
- Department of Psychiatry and Neuropsychology Maastricht University Maastricht Netherlands
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15
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Visser LN, Dubbelman MA, Verrijp M, Wanders L, Pelt S, Zwan MD, Thijssen DH, Wouters H, Sikkes SA, van Hout HP, van der Flier WM. The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population. Alzheimers Dement (Amst) 2021; 13:e12234. [PMID: 34541288 PMCID: PMC8438682 DOI: 10.1002/dad2.12234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/01/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. METHODS Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. RESULTS Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. CONCLUSION With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.
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Affiliation(s)
- Leonie N.C. Visser
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Mark A. Dubbelman
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - Merike Verrijp
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - Lisa Wanders
- Radboud Institute for Health SciencesDepartment of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
- Top Institute Food and NutritionWageningenThe Netherlands
| | - Sophie Pelt
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - Marissa D. Zwan
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - Dick H.J. Thijssen
- Radboud Institute for Health SciencesDepartment of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Hans Wouters
- General Practitioners Research InstituteGroningenThe Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
- Faculty of Behavioural and Movement SciencesClinical Developmental Psychology & Clinical NeuropsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Hein P.J. van Hout
- Department of General Practice and Medicine for Older PersonsAmsterdam Institute for Public Health Care ResearchVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam UMCAmsterdamThe Netherlands
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16
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Zwan MD, van der Flier WM, Cleutjens S, Schouten TC, Vermunt L, Jutten RJ, van Maurik IS, Sikkes SA, Flenniken D, Howell T, Weiner MW, Scheltens P, Prins ND. Dutch Brain Research Registry for study participant recruitment: Design and first results. Alzheimers Dement (N Y) 2021; 7:e12132. [PMID: 33614897 PMCID: PMC7882519 DOI: 10.1002/trc2.12132] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The Dutch Brain Research Registry aims to facilitate online recruitment of participants for brain disease studies. METHODS Registrants were primarily recruited through an online social media campaign. The registration process included a short questionnaire, which was subsequently used in the prescreening process to match participants to studies. RESULTS In the first 18 months, 17,218 registrants signed up (58±11 years old, 78% female). Out of 34,696 study invitations that were sent, 36% were accepted by registrants, of which 50% to 84% were finally enrolled, resulting in 10,661 participants in 28 studies. Compared to non-participants, study participants were more often older, male, more highly educated, retired or unemployed, non-smoking, healthier, and more often had a family member with dementia. DISCUSSION The Dutch Brain Research Registry facilitates effective matching of participants to brain disease studies. Participant factors related to study enrollment may reflect facilitators or barriers for participation, which is useful for improving recruitment strategies.
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Affiliation(s)
- Marissa D. Zwan
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Wiesje M. van der Flier
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Solange Cleutjens
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Tamara C Schouten
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Lisa Vermunt
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Clinical ChemistryNeurochemistry LaboratoryAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Roos J. Jutten
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Ingrid S. van Maurik
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Sietske A.M. Sikkes
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
| | - Taylor Howell
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
| | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Philip Scheltens
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Niels D. Prins
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
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17
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Boada M, Winblad B, Jessen F, Visser PJ, Kramberger MG, Rodrigo A, Simó R, Rodriguez O, Sannemann L, Bon J, Zwan MD, Alegret M, Sanabria A, Rosende‐Roca M, Krivec D, Jamilis L, Trigueros P, Kivipelto M, Johansson G, Wimo A, Valero S, Shering C, Glaysher B, Tarraga L, Dumas A, Georges J, Campo L. Pre‐screening models for patient engagement: The MOPEAD project. Alzheimers Dement 2020. [DOI: 10.1002/alz.044796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mercè Boada
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institutet Solna Sweden
- Karolinska University Hospital, Theme Aging Huddinge Sweden
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
- Department of Psychiatry and Psychotherapy University of Cologne, Medical Faculty Cologne Germany
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience Campus VU University Medical Center Amsterdam Netherlands
| | | | - Adrián Rodrigo
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | - Rafael Simó
- Institut de Recerca Hospital Universitari Vall d’Hebron (VHIR) Barcelona Spain
| | - Octavio Rodriguez
- Research Center and Memory Clinic., Fundació ACE, Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya Barcelona Spain
| | - Lena Sannemann
- Department of Psychiatry University of Cologne Cologne Germany
| | - Jaka Bon
- University Medical Centre Ljubljana Ljubljana Slovenia
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Montserrat Alegret
- Research Center and Memory Clinic., Fundació ACE, Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya Barcelona Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED) Instituto de Salud Carlos III Madrid Spain
| | - Angela Sanabria
- Networking Research Center on Neurodegenerative Diseases (CIBERNED) Instituto de Salud Carlos III Madrid Spain
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
| | - Maitee Rosende‐Roca
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades ‐ Universitat Internacional de Catalunya (UIC) Barcelona Spain
| | - David Krivec
- Spomincica — Alzheimer Slovenia Ljubljana Slovenia
| | - Laura Jamilis
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | | | - Miia Kivipelto
- Institute of Clinical Medicine/neurology University of Eatern Finland Kuopio, Finland Kuopio Finland
- Division of Clinical Geriatrics Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society Karolisnka Institutet Stockholm, Sweden Stockholm Sweden
| | - Gunilla Johansson
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institutet Solna Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institutet Solna Sweden
| | - Sergi Valero
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED). Instituto de Salud Carlos III Madrid Spain
| | | | | | - Lluis Tarraga
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III Madrid Spain
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades ‐ Universitat Internacional de Catalunya (UIC) Barcelona Spain
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18
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Collij L, Salvadó G, Alves IL, Reimand J, Wink AM, Zwan MD, Niñerola‐Baizán A, Perissinotti A, Scheltens P, Farrar G, Buckley C, Molinuevo JL, Barkhof F, Van Berckel BN, Gispert JD. Examining centiloid quantification against visual assessment using [18F]flutemetamol PET. Alzheimers Dement 2020. [DOI: 10.1002/alz.042653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lyduine Collij
- Amsterdam UMC VU University Medical Center Amsterdam Netherlands
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | | | - Juhan Reimand
- VU University Medical Center Amsterdam UMC Amsterdam Netherlands
| | - Alle Meije Wink
- VU University Medical Center Amsterdam Neuroscience Amsterdam Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | - Philip Scheltens
- Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Frederik Barkhof
- Department of Computer Science and Centre for Medical Image Computing University College London London United Kingdom
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19
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Sannemann L, Müller T, Waterink L, Zwan MD, Wimo A, Stomrud E, Pino S, Espinosa JA, Rodriguez‐Gomez O, Benaque A, Bon J, Dron A, Ferreira D, Johansson G, Dumas A, Georges J, Kramberger MG, Visser PJ, Winblad B, Campo L, Boada M, Jessen F. General practitioners’ opinion on early and pre‐dementia diagnosis of AD: A MOPEAD project survey in five European countries. Alzheimers Dement 2020. [DOI: 10.1002/alz.040357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lena Sannemann
- University of Cologne, Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Theresa Müller
- University of Cologne, Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Lisa Waterink
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet Solna Sweden
| | - Erik Stomrud
- Emmaboda Health Centre, Region Kalmar County Emmaboda Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Susana Pino
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
| | | | - Octavio Rodriguez‐Gomez
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
| | - Alba Benaque
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades ‐ Universitat Internacional de Catalunya Barcelona Spain
| | - Jaka Bon
- University Medical Centre Ljubljana Ljubljana Slovenia
| | - Amanda Dron
- Modus Research and Innovation Limited Dundee United Kingdom
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society Karolinska Institutet Stockholm Sweden
| | - Gunilla Johansson
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet Solna Sweden
| | | | | | | | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet Solna Sweden
- Karolinska University Hospital, Theme Aging, Huddinge Sweden
| | | | - Mercè Boada
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
| | - Frank Jessen
- University of Cologne, Faculty of Medicine and University Hospital Cologne Cologne Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Uniklinik Köln Köln Germany
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20
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Wimo A, Belger M, Bon J, Vugt M, Jessen F, Kramberger MG, Jamilis L, Johansson G, Rodrigo A, Rodriguez‐Gomez O, Sannemann L, Stoekenbroek M, Stomrud E, Gurrutxaga M, Valero S, Vermunt L, Waterink L, Winblad B, Zwan MD, Boada M. A cost‐consequence analysis of early detection of AD in the MOPEAD project — A project within the EU research agenda IMI‐2. Alzheimers Dement 2020. [DOI: 10.1002/alz.042774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Anders Wimo
- Karolinska Institutet Dept for Neurobiology, Care Sciences and Society Center for Alzheimer Research Div of Neurogeriatrics Solna Sweden
| | - Mark Belger
- Eli Lilly and Company Windlesham United Kingdom
| | - Jaka Bon
- University Medical Centre Ljubljana Ljubljana Slovenia
| | - Marjolein Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Frank Jessen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie Uniklinik Köln Köln Germany
| | | | - Laura Jamilis
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | | | - Adrián Rodrigo
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | - Octavio Rodriguez‐Gomez
- CIBERNED Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
| | - Lena Sannemann
- University of Cologne Faculty of Medicine and University Hospital Cologne Cologne Germany
| | | | - Erik Stomrud
- Memory Clinic Skåne University Hospital Malmö Sweden
| | | | - Sergi Valero
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades ‐ Universitat Internacional de Catalunya (UIC) Barcelona Spain
| | - Lisa Vermunt
- Alzheimer Center Amsterdam, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Lisa Waterink
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | | | - Marissa D. Zwan
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Mercè Boada
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades ‐ Universitat Internacional de Catalunya (UIC) Barcelona Spain
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21
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Zwan MD, van Der Flier W, Cleutjens S, Vermunt L, Jutten RJ, van Maurik IS, Sikkes SAM, Weiner MW, Scheltens P, Prins ND. Dutch Brain Research Registry for online study participant recruitment: Design and first results. Alzheimers Dement 2020. [DOI: 10.1002/alz.044738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marissa D Zwan
- Amsterdam University Medical Centers Amsterdam Netherlands
| | - Wiesje van Der Flier
- Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | - Lisa Vermunt
- Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Roos J. Jutten
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Ingrid S van Maurik
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | - Michael W Weiner
- UCSF Department of Radiology and Biomedical Imaging San Francisco CA USA
| | - Philip Scheltens
- Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Niels D Prins
- Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
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22
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Jeon Y, Fargo K, Smith A, Langbaum JB, Nosheny RL, Zwan MD, Shin M, Scheltens P, Weiner MW, Rossor MN. Comparison of digital platforms for participant recruitment in dementia research: Lessons and future directions from a global collaborative. Alzheimers Dement 2020. [DOI: 10.1002/alz.046401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Adam Smith
- University College London London United Kingdom
| | | | - Rachel L Nosheny
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
| | | | - Mirim Shin
- The University of Sydney Sydney Australia
| | | | - Michael W Weiner
- UCSF Department of Radiology and Biomedical Imaging San Francisco CA USA
| | - Martin N Rossor
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
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23
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Masselink LA, Visser LNC, Cleutjens S, van der Lee SJ, van der Schaar J, Scheltens P, van Der Flier W, Zwan MD. Attitudes towards genetic susceptibility testing for Alzheimer’s disease dementia in cognitively normal adults: A survey study. Alzheimers Dement 2020. [DOI: 10.1002/alz.047393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Leonie NC Visser
- Academic Medical Center/University of Amsterdam Amsterdam Netherlands
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24
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Verrijp M, Dubbelman MA, Nijhuis EW, Visser LNC, Zwan MD, Jutten RJ, Van Hout HPJ, van Der Flier W, Scheltens P, Sikkes SAM. Study partner‐ and self‐reported difficulties in cognitively complex everyday activities in participants without objective cognitive impairment. Alzheimers Dement 2020. [DOI: 10.1002/alz.046015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Merike Verrijp
- Alzheimer Center VU University Medical Center Amsterdam Netherlands
| | - Mark A Dubbelman
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Elke W Nijhuis
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Leonie NC Visser
- Academic Medical Center/University of Amsterdam Amsterdam Netherlands
| | | | - Roos J Jutten
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
| | | | - Wiesje van Der Flier
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
| | | | - Sietske AM Sikkes
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
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25
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Winblad B, Jessen F, Kramberger MG, Visser PJ, Rodrigo A, Jamilis L, Rodriguez‐Gomez O, Sannemann L, Zwan MD, Bon J, Johansson G, Nelvig A, Haglund A, Jelic V, Campo L, Wimo A, Boada M, Consortium MOPEAD. The IMI‐EU H2020 project MOPEAD: Outcome of different screening methods to identify MCI/early AD. Alzheimers Dement 2020. [DOI: 10.1002/alz.044524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet Solna Sweden
| | - Frank Jessen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie Uniklinik Köln Köln Germany
| | | | | | - Adrián Rodrigo
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | - Laura Jamilis
- GMV Soluciones Globales Internet S.A.U. Tres Cantos Spain
| | | | - Lena Sannemann
- University of Cologne, Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Jaka Bon
- University Medical Centre Ljubljana Ljubljana Slovenia
| | | | | | | | | | - Laura Campo
- Eli Lilly and Company Ltd Basingstoke United Kingdom
| | - Anders Wimo
- Karolinska Institutet, Department for Neurobiology Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics Solna Sweden
| | - Mercè Boada
- Fundació ACE. Barcelona Alzheimer Treatment and Research Center Barcelona Spain
| | - MOPEAD Consortium
- MOPEAD Consortium, Fundació ACE, Barcelona Alzheimer Treatment and Research Center Barcelona Spain
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26
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Verberk IMW, Thijssen E, Koelewijn J, Mauroo K, Vanbrabant J, de Wilde A, Zwan MD, Verfaillie SCJ, Ossenkoppele R, Barkhof F, van Berckel BNM, Scheltens P, van der Flier WM, Stoops E, Vanderstichele HM, Teunissen CE. Combination of plasma amyloid beta (1-42/1-40) and glial fibrillary acidic protein strongly associates with cerebral amyloid pathology. Alzheimers Res Ther 2020; 12:118. [PMID: 32988409 PMCID: PMC7523295 DOI: 10.1186/s13195-020-00682-7] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/10/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Blood-based biomarkers for Alzheimer's disease (AD) might facilitate identification of participants for clinical trials targeting amyloid beta (Abeta) accumulation, and aid in AD diagnostics. We examined the potential of plasma markers Abeta(1-42/1-40), glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) to identify cerebral amyloidosis and/or disease severity. METHODS We included individuals with a positive (n = 176: 63 ± 7 years, 87 (49%) females) or negative (n = 76: 61 ± 9 years, 27 (36%) females) amyloid PET status, with syndrome diagnosis subjective cognitive decline (18 PET+, 25 PET-), mild cognitive impairment (26 PET+, 24 PET-), or AD-dementia (132 PET+). Plasma Abeta(1-42/1-40), GFAP, and NfL were measured by Simoa. We applied two-way ANOVA adjusted for age and sex to investigate the associations of the plasma markers with amyloid PET status and syndrome diagnosis; logistic regression analysis with Wald's backward selection to identify an optimal panel that identifies amyloid PET positivity; age, sex, and education-adjusted linear regression analysis to investigate associations between the plasma markers and neuropsychological test performance; and Spearman's correlation analysis to investigate associations between the plasma markers and medial temporal lobe atrophy (MTA). RESULTS Abeta(1-42/1-40) and GFAP independently associated with amyloid PET status (p = 0.009 and p < 0.001 respectively), and GFAP and NfL independently associated with syndrome diagnosis (p = 0.001 and p = 0.048 respectively). The optimal panel identifying a positive amyloid status included Abeta(1-42/1-40) and GFAP, alongside age and APOE (AUC = 88% (95% CI 83-93%), 82% sensitivity, 86% specificity), while excluding NfL and sex. GFAP and NfL robustly associated with cognitive performance on global cognition and all major cognitive domains (GFAP: range standardized β (sβ) = - 0.40 to - 0.26; NfL: range sβ = - 0.35 to - 0.18; all: p < 0.002), whereas Abeta(1-42/1-40) associated with global cognition, memory, attention, and executive functioning (range sβ = 0.22 - 0.11; all: p < 0.05) but not language. GFAP and NfL showed moderate positive correlations with MTA (both: Spearman's rho> 0.33, p < 0.001). Abeta(1-42/1-40) showed a moderate negative correlation with MTA (Spearman's rho = - 0.24, p = 0.001). DISCUSSION AND CONCLUSIONS Combination of plasma Abeta(1-42/1-40) and GFAP provides a valuable tool for the identification of amyloid PET status. Furthermore, plasma GFAP and NfL associate with various disease severity measures suggesting potential for disease monitoring.
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Affiliation(s)
- Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. .,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Elisabeth Thijssen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Jannet Koelewijn
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | | | | | - Arno de Wilde
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sander C J Verfaillie
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,UCL Institutes of Neurology and Healthcare Engineering, London, UK
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | | | | | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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27
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Golla SS, Verfaillie SC, Boellaard R, Adriaanse SM, Zwan MD, Schuit RC, Timmers T, Groot C, Schober P, Scheltens P, van der Flier WM, Windhorst AD, van Berckel BN, Lammertsma AA. Quantification of [ 18F]florbetapir: A test-retest tracer kinetic modelling study. J Cereb Blood Flow Metab 2019; 39:2172-2180. [PMID: 29897009 PMCID: PMC6826855 DOI: 10.1177/0271678x18783628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Accumulation of amyloid beta can be visualized using [18F]florbetapir positron emission tomography. The aim of this study was to identify the optimal model for quantifying [18F]florbetapir uptake and to assess test-retest reliability of corresponding outcome measures. Eight Alzheimer's disease patients (age: 67 ± 6 years, Mini-Mental State Examination (MMSE): 23 ± 3) and eight controls (age: 63 ± 4 years, MMSE: 30 ± 0) were included. Ninety-minute dynamic positron emission tomography scans, together with arterial blood sampling, were acquired immediately following a bolus injection of 294 ± 32 MBq [18F]florbetapir. Several plasma input models and the simplified reference tissue model (SRTM) were evaluated. The Akaike information criterion was used to identify the preferred kinetic model. Compared to controls, Alzheimer's disease patients had lower MMSE scores and evidence for cortical Aβ pathology. A reversible two-tissue compartment model with fitted blood volume fraction (2T4k_VB) was the preferred model for describing [18F]florbetapir kinetics. SRTM-derived non-displaceable binding potential (BPND) correlated well (r2 = 0.83, slope = 0.86) with plasma input-derived distribution volume ratio. Test-retest reliability for plasma input-derived distribution volume ratio, SRTM-derived BPND and SUVr(50-70) were r = 0.88, r = 0.91 and r = 0.86, respectively. In vivo kinetics of [18F]florbetapir could best be described by a reversible two-tissue compartmental model and [18F]florbetapir BPND can be reliably estimated using an SRTM.
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Affiliation(s)
- Sandeep Sv Golla
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Sander Cj Verfaillie
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Ronald Boellaard
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sofie M Adriaanse
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Marissa D Zwan
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Robert C Schuit
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Tessa Timmers
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Colin Groot
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Patrick Schober
- Department of Anaesthesiology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Epidemiology & Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert D Windhorst
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Bart Nm van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
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28
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Fruijtier AD, Visser LNC, van Maurik IS, Zwan MD, Bouwman FH, van der Flier WM, Smets EMA. ABIDE Delphi study: topics to discuss in diagnostic consultations in memory clinics. Alzheimers Res Ther 2019; 11:77. [PMID: 31472676 PMCID: PMC6717649 DOI: 10.1186/s13195-019-0531-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022]
Abstract
Background Information given to patients and caregivers during the clinician-patient encounter varies considerably between memory clinic professionals. Patients and caregivers express a clear desire for more information. It is unclear what information patients and caregivers value most during the diagnostic process and whether this is concordant with professionals’ opinion. We aimed to identify a topic list on which health care professionals, patients, and caregivers agree that these should be discussed during diagnostic consultations in memory clinics. Further, we aimed to establish the optimal moment for each topic to be discussed during the diagnostic process. Methods We performed a three-round Delphi consensus study. Professionals (N = 80), patients (N = 66), and caregivers (N = 76) rated the importance of 44 informative topics through an online questionnaire. Consensus was defined as a topic rating of 6 or 7 on a 7-point Likert scale by ≥ 75% of each panel. In round 2 and 3, a survey was added to identify the optimal moment during the diagnostic process to discuss each topic. Results By round 3, consensus was achieved on 17 topics divided into four categories, information about (1) diagnostic testing, (2) test results, (3) diagnosis, and (4) practical implications. Eight additional topics showed significant differences between panels. Most notable panel differences regard the risk for developing dementia and the distinction between Alzheimer’s disease and dementia, which patients and caregivers evaluated as more important compared to professionals. The optimal moment to discuss topics during the diagnostic process was identified for the 17 core topics, and the eight topics with significant differences. Conclusions We present a core list of informative topics, which professionals, patients, and caregivers agree they should be discussed during the diagnostic process in a memory clinic. The topic list can support professionals and empower patients and caregivers during diagnostic physician-patient consultations. Electronic supplementary material The online version of this article (10.1186/s13195-019-0531-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Agnetha D Fruijtier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. .,Department of Medical Psychology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Leonie N C Visser
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.,Department of Medical Psychology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ingrid S van Maurik
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marissa D Zwan
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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29
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van Maurik IS, Visser LN, Pel-Littel RE, van Buchem MM, Zwan MD, Kunneman M, Pelkmans W, Bouwman FH, Minkman M, Schoonenboom N, Scheltens P, Smets EM, van der Flier WM. Development and Usability of ADappt: Web-Based Tool to Support Clinicians, Patients, and Caregivers in the Diagnosis of Mild Cognitive Impairment and Alzheimer Disease. JMIR Form Res 2019; 3:e13417. [PMID: 31287061 PMCID: PMC6643768 DOI: 10.2196/13417] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 12/31/2022] Open
Abstract
Background As a result of advances in diagnostic testing in the field of Alzheimer disease (AD), patients are diagnosed in earlier stages of the disease, for example, in the stage of mild cognitive impairment (MCI). This poses novel challenges for a clinician during the diagnostic workup with regard to diagnostic testing itself, namely, which tests are to be performed, but also on how to engage patients in this decision and how to communicate test results. As a result, tools to support decision making and improve risk communication could be valuable for clinicians and patients. Objective The aim of this study was to present the design, development, and testing of a Web-based tool for clinicians in a memory clinic setting and to ascertain whether this tool can (1) facilitate the interpretation of biomarker results in individual patients with MCI regarding their risk of progression to dementia, (2) support clinicians in communicating biomarker test results and risks to MCI patients and their caregivers, and (3) support clinicians in a process of shared decision making regarding the diagnostic workup of AD. Methods A multiphase mixed-methods approach was used. Phase 1 consisted of a qualitative needs assessment among professionals, patients, and caregivers; phase 2, consisted of an iterative process of development and the design of the tool (ADappt); and phase 3 consisted of a quantitative and qualitative assessment of usability and acceptability of ADappt. Across these phases, co-creation was realized via a user-centered qualitative approach with clinicians, patients, and caregivers. Results In phase 1, clinicians indicated the need for risk calculation tools and visual aids to communicate test results to patients. Patients and caregivers expressed their needs for more specific information on their risk for developing AD and related consequences. In phase 2, we developed the content and graphical design of ADappt encompassing 3 modules: a risk calculation tool, a risk communication tool including a summary sheet for patients and caregivers, and a conversation starter to support shared decision making regarding the diagnostic workup. In phase 3, ADappt was considered to be clear and user-friendly. Conclusions Clinicians in a memory clinic setting can use ADappt, a Web-based tool, developed using multiphase design and co-creation, for support that includes an individually tailored interpretation of biomarker test results, communication of test results and risks to patients and their caregivers, and shared decision making on diagnostic testing.
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Affiliation(s)
- Ingrid S van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Leonie Nc Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Medical Psychology, Amsterdam Public Health Research Insitute, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | | | - Marieke M van Buchem
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Marleen Kunneman
- Department of Medical Psychology, Amsterdam Public Health Research Insitute, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
| | - Wiesje Pelkmans
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Mirella Minkman
- Vilans Center of Expertise for Long Term Care, Utrecht, Netherlands.,Tilburg University, TIAS School for Business and Society, Tilburg, Netherlands
| | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Ellen Ma Smets
- Department of Medical Psychology, Amsterdam Public Health Research Insitute, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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30
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Fruijtier AD, Visser LN, Van Maurik IS, Zwan MD, Bouwman FH, van der Flier WM, Smets EM. O2-01-03: ABIDE DELPHI STUDY: TOPICS TO DISCUSS IN DIAGNOSTIC CONSULTATIONS IN MEMORY CLINICS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Agnetha D. Fruijtier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC, Netherlands; Amsterdam Netherlands
- Department of Medical Psychology, Amsterdam Public Health Research Institute; University of Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Leonie N.C. Visser
- Department of Medical Psychology, Amsterdam Public Health Research Institute; University of Amsterdam, Amsterdam UMC; Amsterdam Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Ingrid S. Van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
- Department of Epidemiology and Biostatistics; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Femke H. Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Ellen M. Smets
- Department of Medical Psychology, Amsterdam Public Health Research Institute; University of Amsterdam, Amsterdam UMC; Amsterdam Netherlands
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31
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Handels R, Zwan MD, Pelkmans W, Bouwman FH, Biessels GJ, Roks G, Schoonenboom NS, Verwey NA, Van Berckel BN, van der Flier WM, Verhey FR, Scheltens P. P2-365: ADDED DIAGNOSTIC VALUE OF 18F-FLUTEMETAMOL PET SCANNING IN YOUNG PATIENTS WITH DEMENTIA. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ron Handels
- Maastricht University; Department of Psychiatry and Neuropsychology; Alzheimer Centre Limburg; School for Mental Health and Neurosciences; Maastricht Netherlands
- Karolinska Institutet; Department for Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Div of Neurogeriatrics; Solna Sweden
| | | | - Wiesje Pelkmans
- Alzheimer Center and Department of Neurology; VU University Medical Center; Amsterdam Netherlands
| | - Femke H. Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht Netherlands
| | - Gerwin Roks
- Elisabeth-TweeSteden Ziekenhuis; Tilburg Netherlands
| | | | | | | | | | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
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32
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Van Maurik IS, Visser LN, Pel-Littel R, van Buchem M, Zwan MD, Kunneman M, Pelkmans W, Bouwman FH, Minkman M, Schoonenboom NS, Scheltens P, Smets EM, van der Flier WM. TD‐P‐25: DEVELOPMENT AND USABILITY OF ADAPPT: AN ONLINE TOOL TO SUPPORT CLINICIANS, PATIENTS AND CAREGIVERS IN THE DIAGNOSIS OF MILD COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ingrid S. Van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Department of Epidemiology and Biostatistics Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Leonie N.C. Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Department of Medical Psychology, Amsterdam Public Health Research Institute University of Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Ruth Pel-Littel
- Vilans Center of Expertise for Long Term Care Utrecht Netherlands
| | - Marieke van Buchem
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marleen Kunneman
- Medical Decision Making, Department of Biomedical Data Sciences Leiden University Medical Center Leiden Netherlands
| | - Wiesje Pelkmans
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Femke H. Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Mirella Minkman
- Vilans Center of Expertise for Long Term Care Utrecht Netherlands
| | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Ellen M. Smets
- Department of Medical Psychology, Amsterdam Public Health Research Institute University of Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Department of Epidemiology and Biostatistics Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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33
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van Maurik IS, Slot RER, Verfaillie SCJ, Zwan MD, Bouwman FH, Prins ND, Teunissen CE, Scheltens P, Barkhof F, Wattjes MP, Molinuevo JL, Rami L, Wolfsgruber S, Peters O, Jessen F, Berkhof J, van der Flier WM. Personalized risk for clinical progression in cognitively normal subjects-the ABIDE project. Alzheimers Res Ther 2019; 11:33. [PMID: 30987684 PMCID: PMC6466790 DOI: 10.1186/s13195-019-0487-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/29/2019] [Indexed: 01/26/2023]
Abstract
Background Biomarkers such as cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) have predictive value for progression to dementia in patients with mild cognitive impairment (MCI). The pre-dementia stage takes far longer, and the interpretation of biomarker findings is particular relevant for individuals who present at a memory clinic, but are deemed cognitively normal. The objective of the current study is to construct biomarker-based prognostic models for personalized risk of clinical progression in cognitively normal individuals presenting at a memory clinic. Methods We included 481 individuals with subjective cognitive decline (SCD) from the Amsterdam Dementia Cohort. Prognostic models were developed by Cox regression with patient characteristics, MRI, and/or CSF biomarkers to predict clinical progression to MCI or dementia. We estimated 5- and 3-year individualized risks based on patient-specific values. External validation was performed on Alzheimer’s Disease Neuroimaging Initiative (ADNI) and an European dataset. Results Based on demographics only (Harrell’s C = 0.70), 5- and 3-year progression risks varied from 6% [3–11] and 4% [2–8] (age 55, MMSE 30) to 38% [29–49] and 28% [21–37] (age 70, MMSE 27). Normal CSF biomarkers strongly decreased progression probabilities (Harrell’s C = 0.82). By contrast, abnormal CSF markedly increased risk (5 years, 96% [56–100]; 3 years, 89% [44–99]). The CSF model could reclassify 58% of the individuals with an “intermediate” risk (35–65%) based on the demographic model. MRI measures were not retained in the models. Conclusion The current study takes the first steps in a personalized approach for cognitively normal individuals by providing biomarker-based prognostic models. Electronic supplementary material The online version of this article (10.1186/s13195-019-0487-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid S van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands. .,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Rosalinde E R Slot
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sander C J Verfaillie
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marissa D Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Niels D Prins
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Brain Research Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Steffen Wolfsgruber
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Willemse EA, van Maurik IS, Tijms BM, Bouwman FH, Franke A, Hubeek I, Boelaarts L, Claus JJ, Korf ES, van Marum RJ, Roks G, Schoonenboom N, Verwey N, Zwan MD, Wahl S, van der Flier WM, Teunissen CE. Diagnostic performance of Elecsys immunoassays for cerebrospinal fluid Alzheimer's disease biomarkers in a nonacademic, multicenter memory clinic cohort: The ABIDE project. Alzheimers Dement (Amst) 2018; 10:563-572. [PMID: 30406175 PMCID: PMC6215060 DOI: 10.1016/j.dadm.2018.08.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction We compared the automated Elecsys and manual Innotest immunoassays for cerebrospinal fluid (CSF) Alzheimer's disease biomarkers in a multicenter diagnostic setting. Methods We collected CSF samples from 137 participants in eight local memory clinics. Amyloid β(1–42) (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau) were centrally analyzed with Innotest and Elecsys assays. Concordances between methods were assessed. Results Biomarker results strongly correlated between assays with Spearman's ρ 0.94 for Aβ42, 0.98 for t-tau, and 0.98 for p-tau. Using Gaussian mixture modeling, cohort-specific cut-points were estimated at 1092 pg/mL for Aβ42, 235 pg/mL for t-tau, and 24 pg/mL for p-tau. We found an excellent concordance of biomarker abnormality between assays of 97% for Aβ42 and 96% for both t-tau and p-tau. Discussion The high concordances between Elecsys and Innotest in this nonacademic, multicenter cohort support the use of Elecsys for CSF Alzheimer's disease diagnostics and allow conversion of results between methods. Method comparison of 137 CSF samples collected in eight nonacademic memory clinics. Innotest and Elecsys strongly correlated: ρ = 0.94 Aβ42; 0.98 t-tau; 0.98 p-tau. Concordances of biomarker abnormalities: 97% Aβ42; 96% t-tau and p-tau. Concordance of NIA-AA–based Alzheimer's disease profile (Aβ42 decreased and p-tau increased): 89%. Preanalytical protocol deviations did not show effects on biomarker correlations.
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Affiliation(s)
- Eline A.J. Willemse
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Corresponding author. Tel.: +31-20-44-43029; Fax: +31-20-44-43857.
| | - Ingrid S. van Maurik
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Betty M. Tijms
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke H. Bouwman
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Isabelle Hubeek
- Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Leo Boelaarts
- Department of Geriatric Medicine, Noordwest Hospital Group, Alkmaar, The Netherlands
| | - Jules J. Claus
- Department of Neurology, Tergooi Hospital, Hilversum, The Netherlands
| | - Esther S.C. Korf
- Department of Neurology, Admiraal De Ruyter Hospital, Goes, The Netherlands
| | - Rob J. van Marum
- Department of Geriatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
- Department of Family Medicine and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gerwin Roks
- Department of Neurology, Elisabeth Tweesteden Hospital (ETZ), Tilburg, The Netherlands
| | | | - Nicolaas Verwey
- Department of Neurology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Marissa D. Zwan
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Wiesje M. van der Flier
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Tijms BM, Vermunt L, Zwan MD, van Harten AC, van der Flier WM, Teunissen CE, Scheltens P, Visser PJ. Pre-amyloid stage of Alzheimer's disease in cognitively normal individuals. Ann Clin Transl Neurol 2018; 5:1037-1047. [PMID: 30250861 PMCID: PMC6144448 DOI: 10.1002/acn3.615] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/11/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To study risk factors for decreasing aβ1-42 concentrations in cerebrospinal fluid (CSF) in cognitively unimpaired individuals with initially normal amyloid and tau markers, and to investigate whether such aβ1-42 decreases are associated with subsequent decline in cognition and other biomarkers of Alzheimer's disease. METHODS Cognitively normal subjects (n = 83, 75 ± 5 years, 35(42%) female) with normal CSF aβ1-42 and tau and repeated CSF sampling were selected from ADNI. Subject level slopes of aβ1-42 decreases were estimated with mixed models. We tested associations of baseline APP processing markers (BACE1 activity, aβ1-40, aβ1-38 and sAPP β) and decreasing aβ1-42 levels by including an interaction term between time and APP marker. Associations between decreasing aβ1-42 levels and clinical decline (i.e., progression to mild cognitive impairment or dementia, MMSE, memory functioning) and biological decline (tau, hippocampal volume, glucose processing and amyloid PET) over a time period of 8-10 years were assessed. RESULTS Aβ1-42 levels decreased annually with -4.6 ± 1 pg/mL. Higher baseline BACE1 activity (β(se) = -0.06(0.03), P < 0.05), aβ1-40 (β(se)= -0.11(.03), P < 0.001), and aβ1-38 levels (β(se) = -0.11(0.03), P < 0.001) predicted faster decreasing aβ1-42. The fastest tertile of decreasing aβ1-42 rates was associated with subsequent pathophysiological processes: 11(14%) subjects developed abnormal amyloid levels after 3 ± 1.7 years, showed increased risk for clinical progression (Hazard Ratio[95CI] = 4.8[1.1-21.0]), decreases in MMSE, glucose metabolism and hippocampal volume, and increased CSF tau and amyloid aggregation on PET (all P < 0.05). INTERPRETATION Higher APP processing and fast decreasing aβ1-42 could be among the earliest, pre-amyloid, pathological changes in Alzheimer's disease.
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Affiliation(s)
- Betty M. Tijms
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Lisa Vermunt
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Marissa D. Zwan
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Argonde C. van Harten
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Charlotte E. Teunissen
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Philip Scheltens
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Pieter Jelle Visser
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdam NeuroscienceAmsterdamThe Netherlands
- Department of Psychiatry & NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
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Rodriguez-Gomez O, Campo L, Datto C, Hundemer HP, Winblad B, Johansson G, Wimo A, Jessen F, Sannemann L, Visser PJ, Zwan MD, Kramberger MG, Simó R, Pérez-Garro I, Rodrigo A, Dumas A, Georges J, Krivec D, Maguire P, Semancik K, Glaysher B, Boada M. P3‐304: MODELS OF PATIENT ENGAGEMENT IN ALZHEIMER'S DISEASE (MOPEAD): A EUROPEAN MULTINATIONAL PROJECT TO DEVELOP AND TEST INNOVATIVE PATIENT ENGAGEMENT STRATEGIES. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Laura Campo
- Eli Lilly and Company LtdBasingstokeUnited Kingdom
| | | | | | - Bengt Winblad
- Karolinska InstitutetCenter for Alzheimer ResearchHuddingeSweden
| | | | - Anders Wimo
- Karolinska InstitutetCenter for Alzheimer ResearchHuddingeSweden
| | - Frank Jessen
- University of CologneMedical FacultyCologneGermany
| | | | | | | | | | - Rafael Simó
- Institut de Recerca Hospital Universitari Vall d'HebronBarcelonaSpain
| | | | | | | | | | | | | | | | | | - Mercè Boada
- Fundació ACEBarcelona Alzheimer Treatment & Research CenterBarcelonaSpain
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Collij L, Konijnenberg E, Reimand J, Kate M, Braber A, Alves IL, Zwan MD, Yaqub MM, Assema D, Wink AM, Lammertsma AA, Scheltens P, Visser PJ, Barkhof F, Berckel BN. IC‐P‐005: ASSESSMENT OF EARLY AMYLOID PATHOLOGY USING [
18
F]FLUTEMETAMOL POSITRON EMISSION TOMOGRAPHY: COMPARING VISUAL READ, SEMI‐QUANTITATIVE AND QUANTITATIVE METHODS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Elles Konijnenberg
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Juhan Reimand
- Alzheimer CenterVU University Medical CenterAmsterdamNetherlands
| | - Mara Kate
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Anouk Braber
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | - Marissa D. Zwan
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | | | | | - Alle Meije Wink
- Department of Radiology and Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | | | - Pieter Jelle Visser
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Frederik Barkhof
- Radiology and Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
- Institutes of Neurology and Healthcare EngineeringUCLLondonUnited Kingdom
| | - Bart N.M. Berckel
- Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
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Zwan MD, Flenniken D, Finley S, Ulbricht A, Nosheny R, Flier WM, Sikkes SA, Scheltens P, Truran-Sacrey D, Weiner M, Prins ND. P1‐602: DUTCH ONLINE REGISTRY FOR RECRUITMENT OF PARTICIPANTS FOR DEMENTIA STUDIES: HERSENONDERZOEK.NL AND BRAIN HEALTH REGISTRY. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Marissa D. Zwan
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- University of California, San FranciscoSan FranciscoCAUSA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Aaron Ulbricht
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Rachel Nosheny
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | | | - Sietske A.M. Sikkes
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
- Harvard Medical SchoolBoston UniversityBostonMAUSA
| | - Philip Scheltens
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Michael Weiner
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- University of California, San FranciscoSan FranciscoCAUSA
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Tijms BM, Willemse EAJ, Zwan MD, Mulder SD, Visser PJ, van Berckel BNM, van der Flier WM, Scheltens P, Teunissen CE. Unbiased Approach to Counteract Upward Drift in Cerebrospinal Fluid Amyloid-β 1-42 Analysis Results. Clin Chem 2017; 64:576-585. [PMID: 29208658 DOI: 10.1373/clinchem.2017.281055] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/20/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Low cerebrospinal fluid (CSF) amyloid-β 1-42 (Aβ 1-42) concentrations indicate amyloid plaque accumulation in the brain, a pathological hallmark of Alzheimer disease (AD). Innotest assay values of Aβ 1-42 have gradually increased over the past 2 decades, which might lead to misclassification of AD when a single cutpoint for abnormality is used. We propose an unbiased approach to statistically correct for drift. METHODS We determined year-specific cutpoints with Gaussian mixture modeling, based on the cross-section of bimodal distributions of Aβ 1-42 concentrations in 4397 memory clinic patients. This allowed us to realign year-specific cutpoints as an unbiased method to remove drift from the data. Sensitivity and specificity to detect AD dementia were compared between corrected and uncorrected values. RESULTS Aβ 1-42 values increased 22 pg/mL annually, and this could not be explained by changes in cohort composition. Our approach removed time dependencies [β (SE) = 0.07 (0.59); P = 0.91]. Statistically correcting for drift improved the sensitivity to detect AD dementia to 0.90 (95% CI, 0.89-0.92) from at least 0.66 (95% CI, 0.64-0.69) based on uncorrected data. Specificity became lower (0.69; 95% CI, 0.67-0.70) vs at most 0.80 (95% CI, 0.79-0.82) for uncorrected data. CONCLUSIONS This approach may also be useful to standardize Aβ 1-42 CSF concentrations across different centers and/or platforms, and to optimize use of CSF biomarker data collected over a long period.
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Affiliation(s)
- Betty M Tijms
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands;
| | - Eline A J Willemse
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Marissa D Zwan
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Sandra D Mulder
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Epidemiology and Biostatistics, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
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van Maurik IS, Zwan MD, Tijms BM, Bouwman FH, Teunissen CE, Scheltens P, Wattjes MP, Barkhof F, Berkhof J, van der Flier WM. Interpreting Biomarker Results in Individual Patients With Mild Cognitive Impairment in the Alzheimer's Biomarkers in Daily Practice (ABIDE) Project. JAMA Neurol 2017; 74:1481-1491. [PMID: 29049480 PMCID: PMC5822193 DOI: 10.1001/jamaneurol.2017.2712] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/24/2017] [Indexed: 12/12/2022]
Abstract
Importance Biomarkers do not determine conversion to Alzheimer disease (AD) perfectly, and criteria do not specify how to take patient characteristics into account. Consequently, biomarker use may be challenging for clinicians, especially in patients with mild cognitive impairment (MCI). Objective To construct biomarker-based prognostic models that enable determination of future AD dementia in patients with MCI. Design, Setting, and Participants This study is part of the Alzheimer's Biomarkers in Daily Practice (ABIDE) project. A total of 525 patients with MCI from the Amsterdam Dementia Cohort (longitudinal cohort, tertiary referral center) were studied. All patients had their baseline visit to a memory clinic from September 1, 1997, through August 31, 2014. Prognostic models were constructed by Cox proportional hazards regression with patient characteristics (age, sex, and Mini-Mental State Examination [MMSE] score), magnetic resonance imaging (MRI) biomarkers (hippocampal volume, normalized whole-brain volume), cerebrospinal fluid (CSF) biomarkers (amyloid-β1-42, tau), and combined biomarkers. Data were analyzed from November 1, 2015, to October 1, 2016. Main Outcomes and Measures Clinical end points were AD dementia and any type of dementia after 1 and 3 years. Results Of the 525 patients, 210 (40.0%) were female, and the mean (SD) age was 67.3 (8.4) years. On the basis of age, sex, and MMSE score only, the 3-year progression risk to AD dementia ranged from 26% (95% CI, 19%-34%) in younger men with MMSE scores of 29 to 76% (95% CI, 65%-84%) in older women with MMSE scores of 24 (1-year risk: 6% [95% CI, 4%-9%] to 24% [95% CI, 18%-32%]). Three- and 1-year progression risks were 86% (95% CI, 71%-95%) and 27% (95% CI, 17%-41%) when MRI results were abnormal, 82% (95% CI, 73%-89%) and 26% (95% CI, 20%-33%) when CSF test results were abnormal, and 89% (95% CI, 79%-95%) and 26% (95% CI, 18%-36%) when the results of both tests were abnormal. Conversely, 3- and 1-year progression risks were 18% (95% CI, 13%-27%) and 3% (95% CI, 2%-5%) after normal MRI results, 6% (95% CI, 3%-9%) and 1% (95% CI, 0.5%-2%) after normal CSF test results, and 4% (95% CI, 2%-7%) and 0.5% (95% CI, 0.2%-1%) after combined normal MRI and CSF test results. The prognostic value of models determining any type of dementia were in the same order of magnitude although somewhat lower. External validation in Alzheimer's Disease Neuroimaging Initiative 2 showed that our models were highly robust. Conclusions and Relevance This study provides biomarker-based prognostic models that may help determine AD dementia and any type of dementia in patients with MCI at the individual level. This finding supports clinical decision making and application of biomarkers in daily practice.
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Affiliation(s)
- Ingrid S. van Maurik
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Marissa D. Zwan
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Betty M. Tijms
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Femke H. Bouwman
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Mike P. Wattjes
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
- Institutes of Neurology and Healthcare Engineering, University College London, London, England
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
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Zwan MD, Flenniken D, Finley S, Nosheny R, Sikkes SA, Flier WM, Scheltens P, Weiner M, Prins ND. [P2–052]: THE DUTCH BRAIN HEALTH REGISTRY: OPTIMIZING RECRUITMENT FOR DEMENTIA RESEARCH. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marissa D. Zwan
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- University of California, San FranciscoSan FranciscoCAUSA
- NCIRESan FranciscoCAUSA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- NCIRESan FranciscoCAUSA
| | - Rachel Nosheny
- University of California, San FranciscoSan FranciscoCAUSA
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco Veterans Affairs Medical CenterSan FranciscoCAUSA
| | - Sietske A.M. Sikkes
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Michael Weiner
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- University of California, San FranciscoSan FranciscoCAUSA
| | - Niels D. Prins
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
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42
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Wilde A, Pelkmans W, Bouwman FH, Verwer J, Groot C, Buchem M, Zwan MD, Ossenkoppele R, Yaqub MM, Kunneman M, Smets EM, Barkhof F, Lammertsma AA, Stephens A, Lier E, Biessels GJ, Berckel BN, Flier WM, Scheltens P. [DT‐01–02]: THE IMPACT OF AMYLOID PET ON DIAGNOSIS AND PATIENT MANAGEMENT IN AN UNSELECTED MEMORY CLINIC COHORT: THE ABIDE PROJECT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Arno Wilde
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
| | | | - Femke H. Bouwman
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
| | - Jurre Verwer
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Colin Groot
- Department of NeurologyUniversity Medical Center UtrechtUtrechtNetherlands
| | - Marieke Buchem
- Department of Radiology and Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Marissa D. Zwan
- Department of Neurology & Alzheimer Center, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Rik Ossenkoppele
- Department of Radiology & Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
| | - Maqsood M. Yaqub
- Academic Medical CenterUniversity of AmsterdamAmsterdamNetherlands
| | | | - Ellen M. Smets
- Radiology & Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
| | - Frederik Barkhof
- Institutes of Neurology and Healthcare Engineering, UCLLondonUnited Kingdom
| | - Adriaan A. Lammertsma
- Department of Radiology & Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | | | | | - Bart N.M. Berckel
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
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43
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Wilde A, Flier WM, Bouwman FH, Ossenkoppele R, Pelkmans W, Groot C, Zwan MD, Yaqub MM, Teunissen CE, Stephens A, Lammertsma AA, Berckel BN, Scheltens P. [P2–207]: CONCORDANCE BETWEEN CEREBROSPINAL FLUID AMYLOID‐β AND [
18
F]FLORBETABEN PET IN AN UNSELECTED COHORT OF MEMORY CLINIC PATIENTS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Arno Wilde
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Femke H. Bouwman
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Rik Ossenkoppele
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | | | - Colin Groot
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Marissa D. Zwan
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Maqsood M. Yaqub
- Department of Radiology & Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | - Adriaan A. Lammertsma
- Department of Radiology & Nuclear Medicine, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Bart N.M. Berckel
- Department of Radiology & Nuclear Medicine, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
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44
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Wilde A, Flier WM, Bouwman FH, Ossenkoppele R, Pelkmans W, Groot C, Zwan MD, Yaqub MM, Teunissen CE, Stephens A, Lammertsma AA, Berckel BN, Scheltens P. [IC‐P‐005]: CONCORDANCE BETWEEN CEREBROSPINAL FLUID AMYLOID‐β AND [
18
F]FLORBETABEN PET IN AN UNSELECTED COHORT OF MEMORY CLINIC PATIENTS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Arno Wilde
- Alzheimer Center, Department of NeurologyVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus AmsterdamVU University Medical Center, Amsterdam, NetherlandsAmsterdamNetherlands
| | - Femke H. Bouwman
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Rik Ossenkoppele
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | | | - Colin Groot
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Marissa D. Zwan
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Maqsood M. Yaqub
- Department of Radiology and Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | - Adriaan A. Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Bart N.M. Berckel
- Department of Radiology and Nuclear Medicine, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
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45
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Zwan MD, Bouwman FH, Konijnenberg E, van der Flier WM, Lammertsma AA, Verhey FRJ, Aalten P, van Berckel BNM, Scheltens P. Diagnostic impact of [ 18F]flutemetamol PET in early-onset dementia. Alzheimers Res Ther 2017; 9:2. [PMID: 28093088 PMCID: PMC5240413 DOI: 10.1186/s13195-016-0228-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 12/08/2016] [Indexed: 12/20/2022]
Abstract
Background Early-onset dementia patients often present with atypical clinical symptoms, hampering an accurate clinical diagnosis. The purpose of the present study was to assess the diagnostic impact of the amyloid-positron emission tomography (PET) imaging agent [18F]flutemetamol in early-onset dementia patients, in terms of change in (confidence in) diagnosis and patient management plan. Methods This prospective bi-center study included 211 patients suspected of early-onset dementia who visited a tertiary memory clinic. Patients were eligible with Mini Mental State Examination ≥ 18 and age at diagnosis ≤ 70 years and in whom the diagnostic confidence was <90% after routine diagnostic work-up. All patients underwent [18F]flutemetamol PET, which was interpreted as amyloid-negative or amyloid-positive based on visual rating. Before and after disclosing the PET results, we assessed the diagnostic confidence (using a visual analog scale of 0–100%) and clinical diagnosis. The impact of [18F]flutemetamol PET on the patient management plan was also evaluated. Results [18F]flutemetamol PET scans were positive in 133 out of 211 (63%) patients, of whom 110 out of 144 (76%) patients had a pre-PET Alzheimer’s disease (AD) diagnosis and 23 out of 67 (34%) patients had a non-AD diagnosis. After disclosure of PET results, 41/211 (19%) diagnoses changed. Overall, diagnostic confidence increased from 69 ± 12% to 88 ± 15% after disclosing PET results (P < 0.001; in 87% of patients). In 79 (37%) patients, PET results led to a change in patient management and predominantly the initiation of AD medication when PET showed evidence for amyloid pathology. Conclusions [18F]flutemetamol PET changed clinical diagnosis, increased overall diagnostic confidence, and altered the patient management plan. Our results suggest that amyloid PET may have added value over the standardized diagnostic work-up in early-onset dementia patients with uncertain clinical diagnosis. This study provides evidence for the recommendations put forward in the appropriate use criteria for amyloid PET in clinical practice. Trial registration Nederlands Trial Register NTR3743. Registered 7 December 2012.
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Affiliation(s)
- Marissa D Zwan
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
| | - Femke H Bouwman
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Elles Konijnenberg
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Frans R J Verhey
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, European Graduate School of Neuroscience EURON, Maastricht University, Maastricht, The Netherlands
| | - Pauline Aalten
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, European Graduate School of Neuroscience EURON, Maastricht University, Maastricht, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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46
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Zwan MD, Villemagne VL, Doré V, Buckley R, Bourgeat P, Veljanoski R, Salvado O, Williams R, Margison L, Rembach A, Macaulay SL, Martins R, Ames D, van der Flier WM, Ellis KA, Scheltens P, Masters CL, Rowe CC. Subjective Memory Complaints in APOEɛ4 Carriers are Associated with High Amyloid-β Burden. J Alzheimers Dis 2016; 49:1115-22. [PMID: 26639956 DOI: 10.3233/jad-150446] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND APOEɛ4 genotype and aging have been identified as risk factors for Alzheimer's disease (AD). In addition, subjective memory complaints (SMC) might be a first clinical expression of the effect of AD pathology on cognitive functioning. OBJECTIVE To assess whether APOEɛ4 genotype, age, SMC, and episodic memory are risk factors for high amyloid-β (Aβ) burden in cognitively normal elderly. METHODS 307 cognitively normal participants (72.7 ± 6.8 years, 53% female, 55% SMC) from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study underwent amyloid PET and APOE genotyping. Logistic regression analyses were performed to determine the association of APOEɛ4 genotype, age, SMC, and episodic memory with Aβ pathology. RESULTS Odds of high Aβ burden were greater at an older age (OR = 3.21; 95% CI = 1.68-6.14), when SMC were present (OR = 1.90; 95% CI = 1.03-3.48), and for APOEɛ4 carriers (OR = 7.49; 95% CI = 3.96-14.15), while episodic memory was not associated with odds of high Aβ burden. Stratified analyses showed that odds of SMC for high Aβ burden were increased in specifically APOEɛ4 carriers (OR = 4.58, 95% CI = 1.83-11.49) and younger participants (OR = 3.73, 95% CI = 1.39-10.01). CONCLUSION Aging, APOEɛ4 genotype, and SMC were associated with high Aβ burden. SMC were especially indicative of high Aβ burden in younger participants and in APOEɛ4 carriers. These findings suggest that selection based on the presence of SMC, APOEɛ4 genotype and age may help identify healthy elderly participants with high Aβ burden eligible for secondary prevention trials.
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Affiliation(s)
- Marissa D Zwan
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia.,The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Vincent Doré
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Rachel Buckley
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Pierrick Bourgeat
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Robyn Veljanoski
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Olivier Salvado
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Rob Williams
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Laura Margison
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Alan Rembach
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | | | - Ralph Martins
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David Ames
- National Ageing Research Institute, Parkville, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Kathryn A Ellis
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Colin L Masters
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
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47
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Wilde A, van der Flier WM, Bouwman FH, Ossenkoppele R, Pelkmans W, Groot C, Zwan MD, Yaqub MM, Newman V, Lammertsma AA, Berckel BN, Scheltens P. P1‐297: The Diagnostic Value of Amyloid Pet in an Unselected Cohort of Memory Clinic Patients. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Arno Wilde
- Alzheimer Center Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. van der Flier
- Alzheimer Center and Neurology Department, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Femke H. Bouwman
- Alzheimer Center and Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | | | - Wiesje Pelkmans
- Alzheimer Center Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | - Colin Groot
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | | | - Maqsood M. Yaqub
- Department of Radiology & Nuclear Medicine VU University Medical CenterAmsterdamNetherlands
| | | | - Adriaan A. Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Bart N.M. Berckel
- Department of Radiology & Nuclear Medicine VU University Medical CenterAmsterdamNetherlands
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48
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Wilde A, van der Flier WM, Bouwman FH, Ossenkoppele R, Pelkmans W, Groot C, Zwan MD, Yaqub MM, Newman V, Lammertsma AA, Berckel BN, Scheltens P. IC‐P‐011: The Diagnostic Value of Amyloid Pet in an Unselected Cohort of Memory Clinic Patients. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Arno Wilde
- Alzheimer Center Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | | | - Femke H. Bouwman
- Alzheimer Center and Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | | | - Wiesje Pelkmans
- Alzheimer Center Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | - Colin Groot
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | | | - Maqsood M. Yaqub
- Department of Radiology and Nuclear Medicine VU University Medical CenterAmsterdamNetherlands
| | | | - Adriaan A. Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Bart N.M. Berckel
- Department of Radiology and Nuclear Medicine VU University Medical CenterAmsterdamNetherlands
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49
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Tijms BM, Bertens D, Zwan MD, Slot RE, Teunissen CE, van der Flier WM, Scheltens P, Visser PJ. P4‐112: Amyloid Levels in the Normal Range are Predictive for Incident Dementia in Non‐Demented Elderly. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Betty M. Tijms
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center and Department of Neurology Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Daniela Bertens
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Marissa D. Zwan
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Rosalinde E.R. Slot
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Charlotte E. Teunissen
- VU University Medical CenterAmsterdamNetherlands
- Neurocampus Amsterdam, VU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. van der Flier
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
| | - Pieter Jelle Visser
- VU University Medical CenterAmsterdamNetherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht UniversityMaastrichtNetherlands
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50
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Kunneman M, van der Flier WM, Bouwman FH, Gillissen F, Schoonenboom NS, Zwan MD, Pel-Littel R, Smets EM. P4‐240: Deciding About Diagnostic Testing for Alzheimer’s Disease: Patients’ Views and Experiences. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marleen Kunneman
- Academic Medical Center, University of AmsterdamAmsterdamNetherlands
| | - Wiesje M. van der Flier
- Alzheimer Center and Neurology Department Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Femke H. Bouwman
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center and Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | | | | | - Marissa D. Zwan
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Ruth Pel-Littel
- Vilans Centre of Expertise for Long-Term CareUtrechtNetherlands
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