Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Alzheimers Dis. 2023;93(1):275-282. doi: 10.3233/JAD-221160.
Alzheimer's disease (AD) biomarkers reflect key elements of pathophysiology and improve the diagnostic process. However, their use in routine clinical practice is still limited.
We aimed to assess neurologists' barriers and enablers to early AD diagnosis using core AD biomarkers.
We conducted an online study in collaboration with the Spanish Society of Neurology. Neurologists answered a survey exploring their attitudes towards AD diagnosis using biomarkers in mild cognitive impairment (MCI) or mild AD dementia. Multivariate logistic regression analyses were conducted to determine the association between neurologists' characteristics and diagnostic attitudes.
We included 188 neurologists with a mean age (SD) of 40.6 (11.3) years, 52.7% male. Most participants had access to AD biomarkers, mainly in cerebrospinal fluid (CSF) (89.9%,#x0025;, n = 169). The majority of participants (95.2%,#x0025;, n = 179) considered CSF biomarkers useful for an etiological diagnosis in MCI. However, 85.6% of respondents (n = 161) used them in less than 60% of their MCI patients in routine clinical practice. Facilitating patients and their families to plan for the future was the most frequent enabler for the use of biomarkers. Short consultation time and practicalities associated with the programming of a lumbar puncture were the most common barriers. A younger neurologist age (p = 0.010) and a higher number of patients managed weekly (p = 0.036) were positively associated with the use of biomarkers.
Most neurologists had a favorable attitude to the use of biomarkers, especially in MCI patients. Improvements in resources and consultation time may increase their use in routine clinical practice.
阿尔茨海默病（AD）生物标志物反映了病理生理学的关键要素，并改善了诊断过程。然而，它们在常规临床实践中的应用仍然有限。
我们旨在使用核心 AD 生物标志物评估神经病学家在早期 AD 诊断方面的障碍和促进因素。
我们与西班牙神经病学学会合作进行了一项在线研究。神经病学家回答了一项调查，该调查探讨了他们在轻度认知障碍（MCI）或轻度 AD 痴呆中使用生物标志物诊断 AD 的态度。进行多变量逻辑回归分析，以确定神经病学家特征与诊断态度之间的关联。
我们纳入了 188 名平均年龄（标准差）为 40.6（11.3）岁、52.7%为男性的神经病学家。大多数参与者可以获得 AD 生物标志物，主要是在脑脊液（CSF）中（89.9%，#x0025;，n = 169）。大多数参与者（95.2%，#x0025;，n = 179）认为 CSF 生物标志物对 MCI 的病因诊断有用。然而，85.6%的受访者（n = 161）在常规临床实践中对不到 60%的 MCI 患者使用这些标志物。帮助患者及其家属规划未来是使用生物标志物的最常见促进因素。咨询时间短和与腰椎穿刺编程相关的实际问题是最常见的障碍。年轻的神经病学家年龄（p = 0.010）和每周管理的患者数量（p = 0.036）与生物标志物的使用呈正相关。
大多数神经病学家对生物标志物的使用持积极态度，尤其是在 MCI 患者中。改善资源和咨询时间可能会增加它们在常规临床实践中的使用。
