Resources of Austrian hospital-based departments of neurology and psychiatry for new amyloid-antibody therapies in early Alzheimer dementia : A survey of the Austrian Alzheimer Society.

BACKGROUND

Disease-modifying therapies with amyloid-antibodies will soon be available for patients with early Alzheimer's disease, which necessitates diagnostic and therapeutic resources in hospital and outpatient settings.

METHODS

The Austrian Alzheimer Society developed an online questionnaire to survey Austrian hospital-based departments of neurology and psychiatry regarding resources for amyloid-antibody therapies.

RESULTS

Between May and October 2023, 30 out of 41 neurology (73%) and 12 out of 33 psychiatry departments (36%) responded. The number of first examinations per year and center ranges between 0 in centers accepting only secondary referrals and 500, median 100. Of the patients 30% (median; range 0-80%) achieve a mini-mental state examination sum score ≥ 22 constituting an early disease stage. First visits comprise medical history, clinical examination, routine blood sampling and neurocognitive screening in 90-100% of patients, magnetic resonance imaging in 90% (median; range 10-100%), amyloid-PET in 5% (0-70%), cerebrospinal fluid analysis (Aß42, Aß40, tau, phospho-tau) in 25% (0-90%) and Apo‑E testing in 2.5% (0-100%). To assess the amyloid status 18 centers (44%) prefer amyloid-PET to lumbar puncture, 20 (49%) vice versa and 15 centers intend to offer amyloid-antibody therapy. Differences between centers and federal states were observed regarding hospital-based resources for amyloid-antibody therapies. A substantial need exists for early dementia diagnosis, medical, neuropsychological, nursing and administrative resources, adequate space, access to amyloid-PET and MRI. All centers highlighted the need for structured patient pathways and multidisciplinary care networks, including neurologists, psychiatrists, radiologists, neuropsychologists operating in clinical practice, rehabilitation and dementia care settings.