Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Alzheimers Dement. 2015 May;11(5):523-32. doi: 10.1016/j.jalz.2014.05.1753. Epub 2014 Aug 22.
We aimed to assess the impact of cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease on decision making and patient management in a tertiary memory clinic.
We included all patients, for 1 year, visiting the VUmc Alzheimer Center for cognitive screening. Neurologists completed questionnaires before and after CSF disclosure. We assessed the change of diagnosis, diagnostic confidence, and impact on patient management.
A total of 438 patients (age 63 ± 8 years, 39% women) were included, of whom 351 (80%) underwent lumbar puncture. After the disclosure of CSF 23/351 diagnoses (7%) were changed. Diagnostic confidence increased from 84% to 89% (P < .001). There were consequences for management in 44/351 patients (13%) with CSF, and 13/87 patients (15%) because of unavailable CSF. There was no effect of age on these results.
CSF biomarkers aid clinicians with decision making during diagnostic work-up of cognitive disorders. This study may be useful for developing guidelines for the implementation of CSF biomarkers in daily practice.
我们旨在评估脑脊液（CSF）生物标志物对三级记忆诊所中阿尔茨海默病决策和患者管理的影响。
我们纳入了在 VUmc 阿尔茨海默病中心进行认知筛查的所有患者，随访时间为 1 年。神经科医生在 CSF 检测结果披露前后填写调查问卷。我们评估了诊断变化、诊断信心和对患者管理的影响。
共纳入 438 例患者（年龄 63±8 岁，39%为女性），其中 351 例（80%）接受了腰椎穿刺。在 CSF 检测结果披露后，23/351 例（7%）的诊断发生了改变。诊断信心从 84%增加到 89%（P<0.001）。有 CSF 结果的 351 例患者中有 44 例（13%）管理措施发生了变化，而无 CSF 结果的 87 例患者中有 13 例（15%）管理措施发生了变化。年龄对这些结果没有影响。
CSF 生物标志物有助于临床医生在认知障碍的诊断评估过程中做出决策。本研究可能有助于制定 CSF 生物标志物在临床实践中应用的指南。
