Yan Jessie T, Dillon Allison, Meng Tong, Ramesh Viviktha, Sabbagh Marwan Noel, Sharma Vishakha, Roth Sophie
Roche Information Solutions Roche Diagnostics Santa Clara California USA.
Genesis Research Hoboken New Jersey USA.
Alzheimers Dement (Amst). 2025 Aug 4;17(3):e70156. doi: 10.1002/dad2.70156. eCollection 2025 Jul-Sep.
This study assessed real-world use of diagnostic tests, such as neuroimaging (e.g., magnetic resonance imaging [MRI], or positron emission tomography [PET]), and computed tomography (CT), cerebrospinal fluid (CSF) biomarker, and blood tests for mild cognitive impairment (MCI), Alzheimer's disease (AD), and other dementias in a large US elderly population.
Medicare fee-for-service data (2015-2020) were used to identify patients aged ≥ 67 newly diagnosed with MCI, AD, or other dementias. Descriptive analyses were conducted to understand the test use within 1 year before disease diagnosis and trends.
Among 653,420 patients (9.1% MCI, 30.3% AD, 60.6% other dementias), 71.9% had blood tests, 53.9% neuroimaging (46.4% CT, 17.7% MRI, and 0.7% PET), and 2.2% CSF test. Test use slightly increased from 2015 to 2020.
Findings from this study suggest low use of diagnostic tests, especially PET and CSF.
Blood tests, magnetic resonance imaging, and computed tomography were predominant for diagnosing mild cognitive impairment, Alzheimer's disease, or other dementias prior to the arrival of disease-modifying therapies.Cerebrospinal fluid biomarker and positron emission tomography tests were infrequently used despite their diagnostic value.The study indicates a modest increase in diagnostic test usage over 6 years between 2015 and 2020.Patients often received combined or repeated diagnostic tests.
本研究评估了诊断测试在现实世界中的使用情况，这些诊断测试包括神经影像学检查（如磁共振成像[MRI]或正电子发射断层扫描[PET]）、计算机断层扫描（CT）、脑脊液（CSF）生物标志物以及血液检测，用于美国大量老年人群中的轻度认知障碍（MCI）、阿尔茨海默病（AD）和其他痴呆症的诊断。
使用医疗保险按服务付费数据（2015 - 2020年）来识别年龄≥67岁且新诊断为MCI、AD或其他痴呆症的患者。进行描述性分析以了解疾病诊断前1年内的测试使用情况及趋势。
在653,420名患者中（9.1%为MCI，30.3%为AD，60.6%为其他痴呆症），71.9%进行了血液检测，53.9%进行了神经影像学检查（46.4%为CT，17.7%为MRI，0.7%为PET），2.2%进行了脑脊液检测。从2015年到2020年，测试使用略有增加。
本研究结果表明诊断测试的使用较少，尤其是PET和脑脊液检测。
在疾病修饰疗法出现之前，血液检测、磁共振成像和计算机断层扫描在诊断轻度认知障碍、阿尔茨海默病或其他痴呆症方面占主导地位。尽管脑脊液生物标志物和正电子发射断层扫描检测具有诊断价值，但使用频率较低。该研究表明2015年至2020年的6年间诊断测试使用量有适度增加。患者经常接受联合或重复的诊断测试。
